MassHealth uses state and federal rules when it decides if you or your family members are eligible for benefits. If you are eligible, you will receive the most complete coverage that you qualify for.

There are some basic rules for getting MassHealth. Even if you or your family already have health insurance, you may be eligible if your family's income is low or medium and:

  • you are a parent living with your children under age 19;
  • you are 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;
  • you have been out of work for a long time;
  • you are disabled;
  • you are HIV positive; or
  • you are a woman under age 65 with breast or cervical cancer.

In deciding family size, MassHealth counts parents (natural, step, and adoptive) and their children under the age of 19 who live with them. If neither parent is living at home, a family group may be children under the age of 19 and a caretaker relative who is not their parent who are all living together. We also count your unborn child (or children) as a member of your family. If you are married and have no children under age 19, we count you and your spouse. A caretaker relative may choose to be part of the family or not.

MassHealth compares your family's monthly income (before taxes and other deductions) to the applicable federal poverty level. If you get income on a weekly basis, we multiply the weekly income by 4.333 to get a monthly amount.

MassHealth updates the federal poverty levels annually based on changes made by the federal government.

This information is provided by MassHealth .