Massachusetts State Seal
The Official Website of the Massachusetts Health Care Training Forum
Health Care Training Forum

New Online Health Connector Hardship Waiver

May 1, 2020

The Health Connector launched a new web page to give members easier access to the Hardship Waiver process. This form can now be accessed from the Health Connector's website at It is available in English and Spanish.

As part of the June premium billing process, all members will get an insert that reminds them that can review their online application and report any changes to their situation or consider applying for a hardship waiver.

In order to receive a waiver or reduction of premiums, members must meet one or more of the outlined criteria in order to be granted a waiver.

To review details about the Health Connector's hardship waiver for ConnectorCare members, review the policy and the criteria here:

If you are helping a member return this form to the Health Connector, note that it can be faxed, mailed or submitted online. When using document upload, be sure to choose the "other" category. The correct mailing address and fax number are listed on the last page of the form.