Instructions for Sending Information For MABD

Have you already completed the booklet “Supplemental Information for Medicaid for the Aged, Blind and Disabled (205SUPP)” that we mailed to you?  
  • If yes, go to Step 2.  
  • If no, go to Step 1.  
Step 1. To get a copy of the booklet, click on the link 205SUPP. Then:  
  • Fill out the booklet on your computer.  
  • Save it to your computer. 
  • Print it. 
  • IMPORTANT: Sign it and put the date you sign it. 
Step 2. There are 2 ways to send us the booklet.  
  • Mail it to: 
Green Mountain Care 
Application and Document Processing Center 
280 State Drive 
Waterbury, VT 05671-1500 
  • OR send it to us using your computer or phone: 
  1. Scan pages 1-4 of your signed booklet on a copy machine to your computer as a PDF or take pictures of pages 1-4 of the booklet using your phone. Do not scan or take pictures of the first 2 pages of the booklet (i and ii)- we don’t need them; they are for you to keep. 
  2. Once you have the PDF file or all pictures ready to send to us, go to on the internet. 
  3. Click on "Healthcare." Then click on “Continue.” 
  4. Click on "Medicaid for Aged, Blind or Disabled, or Pharmacy Program." Then click on “Continue.” 
  5. Fill out the information on this screen. It will help us look up your case. Then click on “Continue.” 
  6. Are you an Assister, Navigator or Authorized Representative? If not, click “no.” Then click on “Continue.” 
  7. Move down the page to where it says "Other" documents. Click on “Choose a document.”  
  8. It will tell you to pick the PDF on your computer or pictures you saved on your phone. Important! Did you take pictures of each page? Then you will have to do steps 7 and 8 for every picture. 
  9. Do you have other papers to send us? You will need to have PDF copies on your computer. OR you can use your phone to take a picture of each paper. Then pick the right name for the paper. Examples: “Pay stub” or “Tax return.” Do this for each paper you need to send us. 
  10. Have you sent us the booklet and all the other papers? Then click "Finish and Submit."   
  11. Did you give us an email address? Then we will email you within 4 hours. We will tell you we got your papers. We will give you a phone number to call if you have questions.  

Contact Information

Green Mountain Care
Health Access Member Services
Department of Vermont Health Access
280 State Dr.
Waterbury, VT 05671-1010
Phone: 1-800-250-8427
Relay services for the Deaf and hard of hearing: 711