Massachusetts Medicaid Eligibility Requirements

This page provides general guidelines for the Massachusetts Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is Massachusetts Office of Health and Human Services. The name of the state program is MassHealth. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the Massachusetts Medicaid office.


Massachusetts Medicaid Overview

The MassHealth program provides comprehensive health insurance-or help in paying for private health insurance-to nearly one million Massachusetts children, families, seniors, and people with disabilities.


Massachusetts Medicaid Eligibility Requirements - Non Income

You must be a Massachusetts resident and a U.S. citizen or qualified alien, and one of the following: a parent living with your children under age 19; 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; or you have been out of work for a long time; or disabled or HIV positive, or you are a woman under 65 with breast cancer or cervical cancer. There's an income limit of up to 300% FPL, depending on what category you are under.


Documents Needed For Massachusetts Medicaid Application


Massachusetts Medicaid Benefits

MassHealth members get similar benefits depending for which MassHealth plan they qualify. There are similar plans with different names for children, adults, families, pregnant women, undocumented immigrants, the disabled and other groups.


Massachusetts Medicaid & CHIP Eligibility Levels

Below is the modified adjusted gross income (MAGI) eligibility levels for Massachusetts Medicaid and Children's Health Insurance Program (CHIP).

Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: 200%
Age 1-5: 150%
Age 6-18: 150%
300% Medicaid: 200%
CHIP: 200%
133% 133%

Eligibility Levels - Individual By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $1,945
Age 1-5: $1,459
Age 6-18: $1,459
$2,918 Medicaid: N/A
CHIP: N/A
$1,293 $1,293

Eligibility Levels - Family Of Two By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,622
Age 1-5: $1,966
Age 6-18: $1,966
$3,933 Medicaid: $2,622
CHIP: $2,622
$1,743 $1,743

Eligibility Levels - Family Of Three By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,298
Age 1-5: $2,474
Age 6-18: $2,474
$4,948 Medicaid: $3,298
CHIP: $3,298
$2,193 $2,193

Eligibility Levels - Family Of Four By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,975
Age 1-5: $2,981
Age 6-18: $2,981
$5,963 Medicaid: $3,975
CHIP: $3,975
$2,643 $2,643