You expect a change in your household size this year (such as marriage, divorce, or a birth or adoption)
You expect a change in income, such as loss or gain of a job, or retirement
This form will calculate your Modified Adjusted Gross Income (MAGI). You will need this number when you apply.
Enter annual amounts below. Include amounts for a spouse if you are married filing jointly for the year or for any dependents who make or expect to make taxable income.
Maryland Health Connection P.O. Box 857 Lanham, MD 20703.