Massachusetts Forms Update
Recently the commonwealth (state) of Massachusetts revised their consumer Medicare guide, A Massachusetts Consumer’s Guide to Medicare. Additionally, there is also an update to the title of the Medigap guide, 2021 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Both of these are required to be left with applicants prior to completing a Massachusetts application.
In order to reflect the change, the MassHealth (Medicaid) Exemptions Acknowledgement Form NLTC-ACK-MA, which needs to be submitted with every Massachusetts application, has been updated.
Beginning Friday, September 10, 2021, the updated documents must be used for all applications in the state of Massachusetts. Click the links above to download a PDF each document. These will also be available on the EssentialLTC Agent Resource Center on Friday, September 10. They can be accessed under the New Business tab and selecting the state of Massachusetts from the State-Specific Applications and Forms dropdown.
| Form Name: | New Form Number: | Replaced Form Number: | Form Use: |
| 2021 Choosing a Medigap Policy: A Guide to Health Insurance for people with Medicare | N/A | N/A | Left with Applicants |
| MassHealth (Medicaid) Exemptions Acknowledgement Form | NLTC-ACK-MA (Rev. 05.21) | NLTC-ACK-MA | Submitted with application |
For agent inquiries contact your dedicated NGL Agent Services Team at 888.505.2332 or status@ngl-essentialltc.com. For sales questions contact the NGL Long-Term Care Sales Team at LTC@nglic.com.
NGL EssenitalLTC – Massachusetts Forms Update
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