If you received a letter telling you to apply for Medicaid for the Aged, Blind and Disabled (MABD), there will be a form included, “Supplemental Information for Medicaid for the Aged, Blind and Disabled (205SUPP)”.
If you did not receive a letter and have not applied for Medicaid through Vermont Health Connect, you must do that first. Visit the Vermont Health Connect website for ways to apply.
- How to apply:
- Use our online application.
- Call us at 1-855-899-9600 Monday-Friday 8AM-4:30PM.
- Contact an in-person assister for help with the application.
- Fill out a paper form (205SUPP) and send it to us.
- Fill out on your computer via a fillable PDF.
Note: If you choose this option you will have to print and sign the form.
2. Submit the 205SUPP form online or mail it to us.
- Online using the Uploader:
- Scan pages 1-4 of your signed form on a copy machine to your computer as a PDF or take pictures of the form using your phone.
- Read the Uploader Instructions.
- Submit the form on the website ahsuploader.vermont.gov.
- Select “healthcare” as the program you are submitting the form for and then upload it.
Green Mountain Care
Application and Document Processing Center
280 State Drive
Waterbury, VT 05671-1500