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MassHealth Basic

This coverage type offers a wide range of health-care benefits to unemployed adults. MassHealth Basic members get their health care when they are enrolled in a health plan through MassHealth. (See Choosing a health plan.)

If you are found eligible for Basic, and think you have a serious disability, call a MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997 for the deaf and hard of hearing). You may be able to get more health-care benefits.

Who can get benefits

You may be eligible for MassHealth Basic if you are under age 65 and:

·          you are currently not working,

·          you have not worked in more than one year; or, if you have worked, you have not earned enough to collect unemployment,

·          you are not eligible to collect unemployment benefits, and

·          you do not have health insurance.

Note: The following people are not eligible for MassHealth Basic:

·          a college student who can get health insurance from his or her college or university, and

·          a person whose spouse works more than 100 hours a month.

Income standards

You must provide proof of your monthly income before taxes and deductions for both you and your spouse. Your family’s monthly income before taxes and deductions can be no more than 133% of the federal poverty level. See MassHealth Income LimitsSee for a chart of the federal poverty levels.

Covered services

In MassHealth Basic, covered services include the ones listed below. There may be some limits. Your health-care provider can explain them.

·          Inpatient hospital services

·          Outpatient services: hospitals, clinics, doctors, dentists (limited dental coverage for adults), family planning, and limited home-health care

·          Medical services: lab tests, X rays, therapies, pharmacy services, dental services, eyeglasses, hearing aids, and medical equipment and supplies

·          Mental health and substance abuse services: inpatient and outpatient

·          Emergency ambulance services

Some of the services not covered

·          Adult day health and adult foster care

·          Hospice

·          Nursing facility services

·          Transportation services, except for emergency ambulance services

Coverage begins

Your health-care coverage begins once you are enrolled in a health plan through MassHealth. For more information, see Choosing a health plan.

Additional Information

A more detailed description of the MassHealth eligibility requirements can be found in the Division’s regulations at 130 CMR 501.000 through 508.000.

A more detailed description of the services covered and any limitations on this coverage can be found in the Division’s regulations at 130 CMR 450.105. You may have a copayment for some services. More information on copayments can be found in the Division’s regulations at 130 CMR 450.130.

NOTE: The Code of Massachusetts Regulations (CMR) is available at:
http://www.lawlib.state.ma.us/cmr.html.

Also see:

MassHealth Overview

Source

Information for this topic was drawn from the MassHealth website (requires Adobe Acrobat Reader) at:
http://www.mass.gov/Eeohhs2/docs/masshealth/appforms/mh_member_booklet.pdf

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