Notice: An emergency special enrollment is open through Dec 15, 2020. The application is available daily from 5 a.m. to 1 a.m.

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Notice: An emergency special enrollment is open through Dec 15, 2020. The application is available daily from 5 a.m. to 1 a.m.

Affidavits

Affidavits

Affidavits

Affidavits

Affidavits

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.

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

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 857, Lanham, MD 20703.
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