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MassHealth Basic Eligibility Standards

There are some basic rules for getting MassHealth. Even if individuals and families already have health insurance, eligibility is possible if:

· MassHealth family group income is low or medium (see each program for income eligibility specifics); and

· the individual is a parent living with his/her children under age 19; or

· the individual is an adult caretaker relative living with children under age 19 who are related by blood, adoption, or marriage, or if the individual is a spouse or former spouse of one of those relatives, and the individual is the primary caretaker of these children when neither parent is living in the home; or

· the individual is under age 19, whether or not residing with his/her family; or

· the individual is pregnant, with or without children; or

· the individual has been out of work for a long time; or

· the individual has a disability.

To receive MassHealth, a form called a Medical Benefit Request must be completed.

The Division of Medical Assistance (DMA) uses State and Federal rules when it decides individual and family eligibility for MassHealth. If found eligible, the most complete coverage for which the individual or MassHealth family group qualifies is provided.

Children who are not found eligible, and who are therefore unable to get MassHealth, may get health-care coverage under the Children's Medical Security Plan (CMSP).

Additional Information

A booklet containing important information about MassHealth is available through a MassHealth Enrollment Center. Call 1-888-665-9993 (TTY: 1-888-665-9997 for the deaf and hard of hearing) to request a booklet or to ask questions about MassHealth eligibility and coverage.

NOTE: Application information may also be downloaded at:
http://www.mass.gov/dma/masshealthinfo/appl_mbr.htm

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MassHealth Basic Eligibility Standards

Additional Information

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