About the program
MassHealth Family Assistance offers coverage to children, some working adults, and people who are HIV positive who cannot get MassHealth Standard or MassHealth CommonHealth.
If you have children under age 19 who live with you, MassHealth Family Assistance:
- pays part of your family's health-insurance premiums if you have or can get qualified health insurance from your employer; or
- allows you to enroll your children in a health plan through MassHealth if you do not have and cannot get other health insurance.
The monthly premium to enroll your child in a health plan is $12 per eligible child, but no more than $84 total for a family. Note: Members of federally recognized American Indian tribes or Alaska Natives do not have to pay premiums.
If you do not have children living with you, MassHealth Family Assistance offers health-insurance coverage by paying part of your employer-sponsored health insurance premiums if:
- you work for a qualified employer who participates in the Insurance Partnership; or
- you are self-employed and meet the MassHealth rules to be a qualified employer.
MassHealth will also give the qualified employer an Insurance Partnership payment to help pay for the insurance.
If you are HIV positive and under age 65, MassHealth Family Assistance may pay part or all of your health-insurance premiums if you have or can get group health insurance from your employer or other source (you will have to pay a member share), and may:
- provide certain medical services not covered by your health insurance; or
- allow you to enroll in the Primary Care Clinician (PCC) Plan if you do not have other health insurance.
Persons enrolled in a health plan through MassHealth get the applicable services listed below. There may be some limits. Your health-care provider can explain them.
- inpatient hospital services
- outpatient services: hospitals, clinics, doctors, dentists, family planning, and vision care
- medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, and 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
Some of the services not covered
The following services are not covered when you are enrolled in a health plan through MassHealth.
- day-habilitation services
- personal-care services
- private-duty nursing services
- nursing-facility services
A complete listing and a more detailed description of the services covered can be found in the MassHealth regulations at 130 CMR 450.105.
You may be able to get MassHealth Family Assistance if you are:
- aged one through 18; or
- under age 65 and working and you
- are not eligible for MassHealth Standard or MassHealth CommonHealth;
- work for a qualified employer who participates in the Insurance Partnership;
- have employer-sponsored health insurance that meets MassHealth standards; and
- pay part of the cost of that health insurance; or
- under age 65 and HIV positive and not eligible for MassHealth Standard or MassHealth CommonHealth.
You must give us proof of your monthly income before taxes. Your family's income before taxes and deductions can be no more than 200% of the federal poverty level. Certain uninsured children may be eligible with income up to 300% of the federal poverty level.
Call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) 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, hard of hearing, or speech disabled)
Office hours: Monday through Friday 9 A.M. to 5 P.M.
This information is provided by MassHealth.