About the program
This coverage type offers coverage to certain unemployed adults by:
- paying for all or part of the cost of your other health-insurance premium; or
- allowing you to enroll in a health plan through MassHealth if you do not have other health insurance.
If MassHealth decides you can get MassHealth Basic, you can get coverage in one of two ways.
- Under premium assistance, MassHealth will pay part or all of your other health-insurance premium. Your benefits will include all those services covered by your other health insurance.
- If you do not have other health insurance, you may enroll in a health plan through MassHealth.
If you are enrolled in a health plan, you may get the services listed below. There may be some limits. Your health-care provider can explain them.
- inpatient hospital services
- outpatient services: hospitals, clinics, doctors, dentists, vision care, and family planning
- medical services: lab tests, X rays, therapies, pharmacy services*, eyeglasses, hearing aids, medical equipment and supplies
- home-health services
- behavioral health (mental health and substance abuse) services
- well-child screenings (for children under the age of 21): including medical, vision, dental, hearing, behavioral health (mental health and substance abuse), and developmental screens, as well as shots
- ambulance services (emergency only)
- quit-smoking services
*If you are eligible for both Medicare and MassHealth, Medicare will provide most of your prescription drug coverage through a Medicare prescription drug plan. Visit www.medicare.gov or call 1-800-MEDICARE for information about whether you need to enroll in a Medicare prescription drug plan, and, if so, how to choose one that is best for you.
Some of the services not covered
- adult day health and adult foster care
- nursing-facility services
A more detailed description of the services covered and any limitations on this coverage can be found in the MassHealth regulations at 130 CMR 450.105. You may have copayments for some services. More information on copayments may be found in the MassHealth regulations at 130 CMR 450.130.
You may be eligible for MassHealth Basic if you are under the age of 65 and you are getting services or are on a waiting list to get services from the Department of Mental Health and:
- you are currently not working;
- you have not worked in more than one year or, if you have worked, you have not earned enough to collect unemployment; and
- you are not eligible to collect unemployment benefits.
Note: The following people are not eligible for MassHealth Basic:
- a college student who can get health insurance from his or her college or university; and
- a person whose spouse works more than 100 hours a month.
Note: This coverage type is available to individuals or members of a couple who are getting Emergency Aid to the Elderly, Disabled and Children (EAEDC) cash assistance.
You must give us proof of your monthly income before taxes. Your family's income before taxes and deductions can be no more than 100% of the federal poverty level.
Call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people who are deaf, heard of hearing, or speech disabled) to request a Medical Benefit Request (MBR), or download a Medical Benefit Request:
Submit the completed application to:
MassHealth Enrollment Center
Central Processing Unit
P.O. Box 290794
Charlestown, MA 02129-0214
MassHealth Customer Service: 1-800-841-2900
(TTY: 1-800-497-4648 for people who are deaf, heard of hearing, or speech disabled)
Office hours: Monday through Friday 9 A.M. to 5 P.M.
This information is provided by MassHealth.