See if you qualify to enroll in health coverage now. The application is available daily from 6 a.m. to 11 p.m.

CREATE ACCOUNT
SIGN IN

See if you qualify to enroll in health coverage now. The application is available daily from 6 a.m. to 11 p.m.

Affidavits

Choose the Right Health Plan Maryland Health Connection

Affidavits

Choose the Right Health Plan Maryland Health Connection

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.

No Current Income
Fluctuating Income
Self-employment Income
Social Security Income
Other 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.
Privacy Settings
We use cookies to enhance your experience while using our website. If you are using our Services via a browser you can restrict, block or remove cookies through your web browser settings. We also use content and scripts from third parties that may use tracking technologies. You can selectively provide your consent below to allow such third party embeds. For complete information about the cookies we use, data we collect and how we process them, please check our Privacy Policy
Youtube
Consent to display content from Youtube
Vimeo
Consent to display content from Vimeo
Google Maps
Consent to display content from Google
Spotify
Consent to display content from Spotify
Sound Cloud
Consent to display content from Sound
Save