MassHealth coverage types for seniors and people who need long-term-care services

Learn about MassHealth coverage types for individuals age 65 years or older and people who need long-term-care services.

Described below are the five MassHealth coverage types offered to eligible seniors and people of any age who need long-term-care services:  Standard, Family Assistance, Limited, Senior Buy-In, and Buy-In. When you complete a Massachusetts Application for Health Coverage for Seniors and People Needing Long-Term-Care Services (SACA-2), MassHealth will determine which program or MassHealth coverage type you can get. MassHealth will give you the most complete coverage that you can get. Your eligibility depends on things like income, citizenship or immigration status, age, and special circumstances. You must be a Massachusetts resident to get any of these services. See the links at the bottom of this page to learn more about eligibility rules and coverage limits and to apply for MassHealth.

 

MassHealth Standard

MassHealth Standard is the most complete coverage offered by MassHealth. It pays for a wide range of health care benefits, including long-term-care services.

Covered services

For MassHealth Standard, covered services include the ones listed below. There may be some limits. 

  • Inpatient hospital services
  • Outpatient services: hospitals, clinics, doctors, dentists, home health care
  • Medical services: lab tests, X-rays, therapy, prescription drugs*, dentures, eyeglasses, hearing aids, medical equipment and supplies 
  • Mental health and addiction services: inpatient and outpatient
  • Hospice services
  • Pharmacy services*
  • Transportation
  • Personal-care-attendant services
  • Long-term-care services 
  • Chronic disease and rehabilitation inpatient hospital services 
  • Adult day health and adult foster care
  • Care and services related to an organ transplant procedure (if approved)
  • Payment of Medicare cost sharing: Medicare Part A and B premiums and nonpharmacy Medicare copayments and deductibles

If you're eligible for both Medicare and MassHealth, Medicare provides most of your prescription drug coverage through a Medicare prescription drug plan. This means you must choose and enroll in a Medicare prescription drug plan. If you don't choose a drug plan, Medicare will choose one for you. You may change plans at any time.

 

MassHealth Family Assistance

MassHealth Family Assistance is available to seniors who meet the income and asset rules for MassHealth Standard, but have an immigration status that keeps them from getting MassHealth Standard. Family Assistance pays for a wide range of health care benefits. Family Assistance doesn't pay for long-term-care services.

Covered services

For MassHealth Family Assistance, covered services include the ones listed below. There may be some limits. 

  • Inpatient hospital services 
  • Outpatient services: hospitals, clinics, doctors, dentists
  • Medical services: lab tests, X-rays, therapy, prescription drugs, dentures, medical equipment and supplies
  • Mental health and addiction services: inpatient and outpatient
  • Pharmacy services
  • Ambulance transportation for an emergency medical condition only

 

MassHealth Limited

MassHealth Limited coverage is available to people 65 and older who meet the income and asset rules for MassHealth Standard or MassHealth Family Assistance, but have an immigration status that keeps them from getting MassHealth Standard or Family Assistance. MassHealth Limited doesn't pay for long-term-care services. MassHealth Limited coverage is for emergency medical services only.

Covered services

MassHealth Limited covers only care for medical emergencies (conditions that could cause serious harm if not treated). Examples of covered services are listed below. There may be some limits. 

  • Inpatient hospital services: emergency services only
  • Outpatient hospital services: emergency services and emergency visits to emergency departments
  • Certain medical services provided by doctors and clinics outside of a hospital
  • Pharmacy services for treating an emergency medical condition
  • Ambulance transportation for an emergency medical condition only
 

MassHealth Senior Buy-In

If you have Medicare, you may qualify for help paying for your Medicare Part A and B premiums and nonpharmacy Medicare copayments and deductibles. Certain MassHealth Standard members may also get this benefit.

Covered services

Payment for Medicare Part A and B premiums and nonpharmacy Medicare copayments and deductibles.

 

MassHealth Buy-In

If you have Medicare and qualify for MassHealth Buy-In, MassHealth will pay for your Medicare Part B premium.

Covered services

Medicare Part B premium payment

 

Additional Resources for MassHealth Buy-In

Feedback

Did you find what you were looking for on this webpage? * required
We use your feedback to help us improve this site but we are not able to respond directly. Please do not include personal or contact information. If you need a response, please locate the contact information elsewhere on this page or in the footer.
We use your feedback to help us improve this site but we are not able to respond directly. Please do not include personal or contact information. If you need a response, please locate the contact information elsewhere on this page or in the footer.

If you need to report child abuse, any other kind of abuse, or need urgent assistance, please click here.

Tell us what you think