HDAP / CHII Application

HDAP/CHII APPLICATION

To enroll in HDAP, you need to fill out an application and submit it along with proof that you live in Massachusetts and proof of your current income (see application instructions below for details). Because HDAP is a “payer of last resort,” you will also need to submit an application to MassHealth or other insurance programs to see if you are eligible in order to enroll in HDAP. If you have a case manager, he or she can help you complete the applications.

Once you are enrolled in HDAP, you will need to recertify your information every six months to stay active in the program.

Click on each image to download a PDF. The English language application is a fillable PDF, but you must first download the PDF in order to save any information that you fill in.

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HDAP English Language Application

HDAP English Language Application Instructions, Client Agreement, and Grievance Procedure

HDAP Spanish Language Application

HDAP-Jail-Application

HDAP Jail Application

All information submitted as part of your HDAP application is kept strictly confidential.

For more information on the status of pending applications or missing documents, please contact HDAP at 617.502.1700.