MassHealth compares your monthly income before deductions to certain limits that are set by law. These limits are based on a percentage of the federal poverty level, and are increased annually. The limits are included on the income and asset charts for individuals and married couples living at home.
If you are married and live with your spouse, we count both of your incomes in deciding if you can get MassHealth.
To determine the amount of your income, we look at the amount of your social security, pension, and other nonwork-related income (after deduction of your Medicare premium, taxes, and other deductions).
If you have income from working, we allow certain deductions. Generally, we count only about half of your monthly income from working before deductions.
If your income is too high to get MassHealth Standard, Essential, or Limited, you will have a deductible.
A deductible is the total amount of your monthly income that is greater than MassHealth's income limits over a six-month period.
To meet your deductible, you must have medical bills that equal or are greater than the amount of your deductible. You may use medical bills for you and your spouse. MassHealth will not pay for these medical bills-they are your responsibility. Also, the bills cannot be for services that are covered by other insurance that you or your spouse may have.
MassHealth looks at the current value of any assets owned by you and compares them to the limits in the income and asset charts for individuals and married couples living at home. If you are married and live with your spouse, we count the value of assets owned by you and your spouse.
Countable assets include the value of bank accounts, certificates of deposit, mutual funds, stocks and bonds, as well as the value of real property other than your home.
Noncountable assets include the home you live in if it is located in Massachusetts, one vehicle per household, and an irrevocable burial trust or prepaid burial contract set up in reasonable amount for future payment of funeral and burial expenses.
As a resident of Massachusetts, if you live in your home and it is not in a trust, we will not count it as an asset. Although we do not count the value of your home, we may ask you to pay for the services you received from MassHealth if you sell your property during your lifetime or we may file a claim against your estate when you die.
If you leave your home to live in a nursing home, special rules apply. We may not count the value of your home if certain people are still living there or if you intend to return home.
You may not reduce your assets by giving them away or transferring them for less than fair-market value. MassHealth checks to see if such transfers occurred within 36 months before your application for MassHealth. In the case of some trusts, MassHealth checks for 60 months prior.
This information is provided by MassHealth.