Dental Blue Freedom for Massachusetts Students

DENTAL BLUE FREEDOM PLAN
2026-2027 Policy Year Enrollment Form

The enrollment deadline is midnight August 15, 2026 for coverage effective September 1, 2026.

Enrollment will be processed AFTER the deadline and once processed, coverage will be effective September 1, 2026 through August 31, 2027.

TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

If you have a social security number you are required to enter it below. If you are an international student and do not have a social security, please use your student ID and add leading zeros if necessary to make it a 9-digit number.