Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth

	Eligibility Operations Memo 09-02
	February 15, 2009

TO:	MassHealth Eligibility Operations Staff

FROM:	Russ Kulp, Director, MassHealth Operations

RE:	Marriage Equality Law

Introduction
On July 31, 2008, Governor Deval Patrick signed into law a measure that allows 
and requires MassHealth to apply existing spousal rules to determine eligibility 
for medical benefits for people in same-gender marriages. MassHealth now 
recognizes state marriage laws in assessing eligibility for all programs 
determined by MassHealth.

Definition of Spouse
The definition of “spouse” in MassHealth regulations at 130 CMR 501.001 
and 515.001 has been revised as follows:

Spouse — a person married to the applicant or member according to the laws of 
the Commonwealth of Massachusetts. Effective for applications and eligibility 
review forms received on or after October 31, 2008, notwithstanding the 
unavailability of federal financial participation, no person who is recognized 
as a spouse under the laws of the Commonwealth will be denied benefits that are 
otherwise available under M.G.L. c. 118E due to the provisions of 1 U.S.C. § 7 
or any other federal non-recognition of spouses of the same gender. If a 
member’s eligibility changes as a result of updated or corrected information 
about marital status, the change in eligibility will be effective as of the date 
the MassHealth agency receives the information, but no sooner than October 
31, 2008.

Eligibility Determinations
For applications and eligibility review forms received on or after October 
31, 2008, any applicant or member who identifies his or her relationship with 
another household member as “spouse” will be treated as such for purpose of 
determining eligibility, regardless of gender. 

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Eligibility Determinations (cont.)
The designation of spouse requires that persons be legally married and has the 
same effect for all married couples with regard to the application of MassHealth 
rules about defining family groups, counting income and assets, establishing 
federal poverty level, the transfer of assets, and spousal impoverishment 
consideration.

Applicants or members who notify MassHealth or indicate marital status on 
MassHealth forms on or after October 31, 2008, will be determined as spouses, 
regardless of gender. Applicants or members must submit all information 
necessary for both spouses in order to determine eligibility. Staff should use 
existing processes for requesting, entering, and updating information.

System Implications- MA21 and PACES
When an applicant or member identifies that he or she is a member of a married 
couple, the household relationships should reflect the appropriate relationship 
as “spouse,” regardless of gender. Applications and eligibility review forms 
should be processed as usual.

Because federal rules do not recognize same-gender marriages, persons in same-
gender marriages whose eligibility is based in any part on marital status will 
receive state-funded benefits and claims for those individuals will not be 
submitted for federal reimbursement. Claims adjustments will be made by the 
federal reporting unit and have no impact on the eligibility process.

Questions
If you have any questions about this memo, please have your MEC designee contact 
the Policy Hotline.