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Massachusetts Medicaid (MassHealth)

Massachusetts Medicaid (MassHealth) pays for health care for certain low and medium income people living in Massachusetts.

Massachusetts Medicaid (MassHealth) pays for health care for certain low and medium income people living in Massachusetts. MassHealth offers health-care benefits directly or by paying part or all of your health-insurance premiums. 

MassHealth offers different types of coverage based on your age, whether you are a parent, pregnant, disabled, HIV positive or have breast or cervical cancer, and whether you work for a small employer. MassHealth will decide if you are eligible and give you the most complete coverage that you qualify for.

Program Name MassHealth
Expanded Medicaid Yes
Website https://www.mass.gov/orgs/masshealth
Phone (800) 841-2900
Apply Online https://www.mahealthconnector.org/
Appeal a Denial Fair Hearing Request
Find a Local Office MassHealth Enrollment Centers

Eligibility Requirements

To be eligible for Massachusetts Medicaid, you must be a resident of the state of Massachusetts, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. ACA Medicaid expansion covers eligible low-income adults.

There is no income limit for individuals with disabilities who may have to pay a premium and a one-time deductible to qualify.

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,131
2 $23,169
3 $29,207
4 $35,245
5 $41,284
6 $47,322
7 $53,360
8 $59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Acute inpatient hospital Hospice
Adult day health Hospital services
Adult foster care Laboratory
Ambulatory prenatal care Medical/surgical supplies
Ambulatory surgery center services Nurse practitioner
Audiologist/hearing services Nursing facility services
Behavioral health Pharmacy
Chiropractor Physician
Dental services Podiatrist
Dialysis services Prosthetic
Durable medical equipment Radiology and diagnostic services
Family planning Therapy (physical, occupational, and speech)
Hearing aids Transportation services
Home health Vision care


Prescription drugs are the only benefit that may have copayments. There are no copayments for other covered services and benefits.

  • $1.00 for certain covered generic drugs and over-the-counter drugs mainly used for diabetes, high blood pressure, and high cholesterol. These drugs are called antihyperglycemics (such as metformin), antihypertensives (such as lisinopril), and antihyperlipidemics (such as simvastatin)
  • $3.65 for each prescription and refill for all other generic, brand-name, and over-the-counter drugs covered by MassHealth

You do not have to pay a MassHealth copayment if:

  • Your income is at or below 50% of the federal poverty level
  • You are eligible for MassHealth because you are getting certain public assistance benefits such as Supplemental Security Income (SSI)
  • You are younger than 21 years of age
  • You are pregnant
  • You are getting benefits under MassHealth Limited (emergency MassHealth)
  • You are an American Indian or Alaska Native
  • You are getting hospice care
  • You have reached a copayment cap

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