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MassHealth Family Assistance Program Overview

Under MassHealth Family Assistance, the Division of Medical Assistance (DMA) may pay part of a covered individual’s health-insurance premiums if he/she works for a qualified employer, if the employer pays at least half of the individual’s health-insurance premium, and the health-insurance plan meets what is called a Basic Benefit Level. A health plan meets the Basic Benefit Level if it provides comprehensive medical coverage to its members, including DMA-required health-care benefits.

If you have children under age 19 who live with you, then MassHealth Family Assistance:

·      pays part of your family’s health-insurance premiums if you have or can get qualified health insurance from your employer, or

·      allows you to enroll your children in a health plan through MassHealth if you do not have and cannot get private health insurance. In 2004, the monthly premium cost to enroll your child in a health plan through MassHealth is $12 per eligible child, but no more than $36 total for a family.

If you do not have children under age 19 living with you, MassHealth Family Assistance offers health-insurance coverage by paying part of your employer-sponsored health-insurance premiums if:

·      you work for a qualified employer who participates in the Insurance Partnership, or

·      you are self-employed and meet the Division’s rules to be a qualified employer.

The Division will also give your qualified employer and the self-employed individual an Insurance Partnership payment for offering and helping to pay for your insurance.

NOTE: For more information about the Insurance Partnership, call 1-800-399-8285.

If you are HIV positive and under age 65, MassHealth Family Assistance may:

·      pay part of your health-insurance premiums if you have or can get group health insurance from your employer or other source; and

·      provide certain medical services not covered by your health insurance; or

·      allow you to enroll in the Division’s Primary Care Clinician (PCC) Plan if you do not have other health insurance.

See Also:

MassHealth Family Assistance Premiums

MassHealth Family Assistance Eligibility

Source

Information for this topic was drawn from the EOHHS website at:
http://www.mass.gov/portal/index.jsp?pageID=eohhs2terminal&L=5&L0=Home&L1=Consumer&L2=MassHealth+and+Insurance&L3=Additional+Insurance+and+Assistance+Programs&L4=Insurance+Partnership&sid=Eeohhs2&b=terminalcontent&f=masshealth_consumer_additional_inspart_employee&csid=Eeohhs2

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