How to Get Massachusetts Medicaid Benefits 

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We have scoured the internet to provide you with all you need to know about the Massachusetts Medicaid Benefits.

Medicaid is a joint federal-state initiative that covers health insurance for low-income people who qualify, including children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, over the phone, or online.

This post will teach you all you need to learn about Medicaid in Massachusetts.

What is Massachusetts Medicaid?

Medicaid is a service for people and families with income and resources that fall inside certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for Massachusetts Medical Program?

Massachusetts Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package partial financial help with Medicare premiums, copayments, or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled, or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled, or who have a spouse who is disabled.

Annual Household Income Limits (before taxes)

Household Size*Maximum Income Level (Per Year)

* Add $6,277 for every extra member in families with 9 or more inhabitants.

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How do I contact Medicaid in Massachusetts?



Mailing Address

MassHealth Customer Service Center Attn: Claims P.O. Box 120010 Boston, MA 02112-0010

How do I apply for Massachusetts Medicaid?

An “Application for Healthcare Insurance for Elderly and People Requiring Long-Term Care Services” can be downloaded here by seniors in Massachusetts. The MassHealth Enrollment Center can be reached by fax at (618) 887-8799 or by mail at P.O. Box 290794, Charlestown, MA 02129-0214, Central Processing Unit, MassHealth Enrollment Center. The MassHealth Enrollment Center, Central Processing Unit is situated in The Schrafft Center, 529 Main Street, Suite 1M, Charlestown, MA 02129-0214, where applicants may also drop off their completed applications. Additionally, you have the choice to submit your application in person at one of six enrollment sites. 

What are the Medicaid plans in Massachusetts?

Massachusetts has been working on several projects to enhance care coordination, raise the standard of care, and cut costs. Initiatives include the below:

  • Patient-Centered Medical Home for MassHealth MCO & PCCM choices
  • Medicaid Share Saving Pilots
  • Pioneer ACO models

For PCCM members, the state implemented a new care management program; a consultant was expected to provide services to up to 4,000 members, pay a monthly fee based on the number of members served, and qualify for rewards for improving patient outcomes based on performance on HEDIS community mental health measure. 

What is covered by Massachusetts Medicaid?

Based on your coverage group—which is decided by your income, age, medical needs, or Patient-Centered Care assistance with daily living—MaineCare pays for medically essential services (ADLs).

The following are some instances of services that might be covered:

  • seeing a doctor
  • Medications on prescription
  • Services for behavioral health
  • Labs and X-rays
  • Hospital and emergency room visits

Can I have both Massachusetts Medicaid and Medicare?

Yes. An individual may be qualified both for Medicaid and Medicare and also be able to take use of both programs simultaneously.

Massachusetts  Waivers

Following are the waivers of Massachusetts:

MA Acquired Brain Injury Non-Residential Habilitation (ABI-N)

For people with brain injuries ages 22 and older, this service offers homemaker, personal services, respite, supported jobs, adult companionship, chores, community-based day supports (CBDS), day assistance, home ease of access adaptations, individual support, and community habilitation, as well as occupational therapists, physical therapy, highly specialized hospital instruments, speech therapy, transition phase assistance, and transportation.

MA Acquired Brain Injury w/Residential Habilitation (ABI-RH)

For people with brain injuries, ages 22 and up, this service offers residential rehabilitation, supported employment, assisted living, community day services, day services, occupational therapists, physical therapy, shared living 24-hour supports, specialized hospital instruments, speech therapy, transitional assistance – RH, and transportation.

MA Adult Supports

Provides practice and support employment, personalized home supports, respite, adult companion, assistive, behaviour supports and discussion, chore, community-based day supports, children start, rehabilitation and adaptations, personal goods and services, person supportive services, personalized day supports, peer, remote continues to support and tracking, specialized medical supplies and equipment, stabilization, and transgender services.

MA Children’s Autism Spectrum Disorder

For kids with autism aged 0 to 8 years old, this organization offers community integration, expanded vocational rehab, homemaker, reprieve, assistive technology, behavioral continues to support and consultation, children start, residence delivered meals, rehabilitation and adaptive responses, personal goods and services, and car modification.

MA Community Living Waiver

Delivers services such as coaching for people with Alzheimer’s and dementia, home health aides, housekeepers, personal care, respite care, chores, companions, complex care training as well as oversight, enhanced new tech individual emergency response systems (PERS), environmental accessibility adjustment, evidence-based education programs, main objective engagement programs, grocery shopping and delivery, home-based wandering response systems, home-delivered meals, and pre-packaged medication delivery.


Some members are exempt from making any copayments. For any MassHealth-insured service, you are not required to make a copayment if:

  • Your yearly salary is at or below the federal poverty line 
  • Because you receive some public assistance payments, including Supplemental Security Income, you are qualified for MassHealth.
  • You are under the age of 21.
  • You are expecting a child or are recovering from giving birth.
  • You are a beneficiary of MassHealth Limited benefits 

You are in a facility providing long-term care, such as

  • a facility for nursing
  • Intermediate-care institution for people with intellectual disabilities, or a hospital for rehabilitation
  • You were transferred from a similar establishment or hospital to a hospital.
  • You’re getting hospice care.
  • You are an American Indian or an Alaska Native who was raised in foster care and who is qualified for MassHealth Standard until age 21 or 26 under regulations found in 130 CMR 505.002(H).

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What is the highest income limit for Massachusetts  Medicaid?

For non-working people, the CommonHealth deductible revenue standard is $542 per month for an individual and $670 for a pair. Effective January 1, 2021, the maximum monthly income for PACE and home and community-based waiver programs is $2382.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for Massachusetts Medicaid thanks to the asset spend down option. Spending down your spare assets on non-countable ones will allow you to qualify.

How much money can you have in the bank on Massachusetts Medicaid?

$4000 for a family of one. $6,000 for a family of two. $25 for each extra member of the family. A resource test is not applied to children under the age. 

Does the disabled person get Massachusetts Medicaid?

Medicaid in Massachusetts is administered. It is a government-run healthcare plan that covers medical costs for those who are pregnant, disabled, young, old, or on a low income.

  • Your Countable Annual Income is $0. 

The federal poverty level is $1,133.of 18 or pregnant women who meet the requirements.

Will you still have Massachusetts Medicaid once you are over 18?

You may be eligible for Medicaid if you are 19 years of age or older or if your family has a low income, irrespective of if you have a handicap but you may hear people refer to it as the “Medicaid expansion.”

What documents do I need to apply for Medicaid?

The following papers must be included with the application.

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origins 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy (doctors’ certification of the pregnancy and, if applicable, the expected delivery date);
  • When non-parents apply for Medicaid according to their own behalf, they must provide proof of their financial position.

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What is the best Medicaid in Massachusetts?

The ideal Medicaid plan for you in Massachusetts will depend on your financial situation as well as other elements.

Since it differs from person to person, the ideal plan for you is the one that fits your needs and provides the most advantages in terms of medical insurance and financial support.

Where do I find the letter showing the reason(s) for denial or discontinuance from Massachusetts Medicaid?

By signing into your account at Portal, you can see the progress of your Massachusetts Medicaid application.

You have three choices on this page: you can verify your eligibility, apply online, or monitor the specifics and progress of your Medicaid application.


You can get information and details through 800-841-2900.

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Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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