MassHealth offers benefits to a wide range of people who meet the eligibility rules. They look at your family size and income to decide if you and your family can get MassHealth. If you are age 65 or older or need long-term-care services, they also count some of your assets. Immigration status does not affect your eligibility for MassHealth, but may affect the type of benefits MassHealth provides.

Basic Eligibility:
MassHealth uses state and federal rules when they decide if you or your family members are eligible for benefits. If you are eligible, you will receive the most complete coverage that you qualify for.

There are some basic rules for getting MassHealth. Even if you or your family already have health insurance, you may be eligible if your family's income is low or medium and:
- you are a parent living with your children under age 19;
- you are an adult caretaker relative living with children under age 19 to whom you are
related by blood, adoption, or marriage, or are a spouse or former spouse of one of
those relatives, and you are the primary caretaker of these children when neither parent
is living in the home;
- you are under age 19, whether or not you live with your family;
- you are pregnant, with or without children;
- you have been out of work for a long time;
- you are disabled; or
- you are HIV positive.

In deciding family size, MassHealth counts parents (natural, step, and adoptive) and their children under the age of 19 who live with them. If neither parent is living at home, a family group may be children under the age of 19 and a caretaker relative who is not their parent who are all living together. We also count your unborn child (or children) as a member of your family. If you are married and have no children under age 19, we count you and your spouse. A caretaker relative may choose to be part of the family or not.

MassHealth compares your family’s monthly income (before taxes and other deductions) to the applicable federal poverty level. If you get income on a weekly basis, we multiply the weekly income by 4.333 to get a monthly amount.

MassHealth updates the federal poverty levels each April based on changes made by the federal government.

How to Apply bt mail: 

To receive MassHealth, you must fill out a form called a Medical Benefit Request. If you do not have an application package and would like to get one, you can download it www.mass.gov/masshealth or call a MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997 for people with partial or total hearing loss). You can also get help filling out the form by calling these numbers.

Your family includes you, your spouse, and your children under age 19, if you are all living together. If neither parent is living in the home, your family group may include children under age 19 and an adult caretaker relative who are all living together. If more than one family lives in your home and wants to apply for MassHealth, they will need to fill out a separate form.

You must supply proof of your monthly income before taxes and deductions for every person in your family. Proof may be two recent pay stubs, a U.S. tax return (if you are self-employed or have rental income), or copies of other check stubs you get, such as from unemployment, or a social security award letter that shows the gross amount (before deductions). If you are self-employed or have rental income, we count your income after allowable deductions.

Mail the Medical Benefit Request and proof of your income to:

MassHealth Enrollment Center
Central Processing Unit
P.O. Box 290794
Charlestown, MA 02129-0214.

Your application package includes a voter registration form. MassHealth Enrollment Center staff can help you fill out this form. Your decision about signing up to vote has no affect on your getting MassHealth.

The Massachusetts Secretary of State's Elections Division has more information on how to register to vote.

MassHealth Member Booklet
http://mass.gov/Eeohhs2/docs/masshealth/appforms/mh_member_booklet.pdf

MassHealth Eligibility Representative Designation Form
http://www.mass.gov/Eeohhs2/docs/masshealth/privacy/erd_english.pdf

Cobra

There was a time when employer-provided group health coverage was at risk if an employee was fired, changed jobs, or got divorced. That substantially changed in 1986 with the passage of the health benefit provisions in the Consolidated Omnibus Budget Reconciliation Act (COBRA). Now, many employees and their families who would lose group health coverage because of serious life events are able to continue their coverage under the employer’s group health plan, at least for limited periods of time