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New rules for Medicaid are coming soon. Find out if these changes apply to you.

Affidavits

Choose the Right Health Plan Maryland Health Connection

Affidavits

Choose the Right Health Plan Maryland Health Connection

Affidavits

Affidavits

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Affidavits

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Home > Affidavits

In some cases, you may sign and upload a written statement using one of these affidavits for different situations including: If you have no income, or income from self-employment.

No Current Income (PDF)
Fluctuating Income (PDF)
Self-employment Income (PDF)
Social Security Income (PDF)
Other Income (PDF)
Exemption from Obtaining a SSN (PDF)
Residency (PDF)
Non-incarceration (PDF)

How to submit documents

  1. Log into your account and upload documents using the link in My Inbox.
  2. Download our free mobile app, Enroll MHC, to submit documents using the camera of your mobile device.
  3. If you are unable to submit documents online, you may mail them to Maryland Health Connection, P.O. Box 249, Lanham, MD 20703.
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