If you live in the state of Massachusetts and you're having trouble purchasing health insurance for yourself or your family because of low income, you may qualify for the MassHealth program. It is a Medicaid program that pays part or all of your health insurance premiums and medical expenses. There are several eligibility requirements, as well as income limits, you must meet to qualify for the program.
Evaluating Eligibility Requirements
Only certain groups of Massachusetts residents are eligible for MassHealth. The program accepts all dependents under age 21. Adults 21 and older must be either a parent of a child under the age of 19, pregnant, disabled, HIV-positive or a woman suffering from breast or cervical cancer.
There is also a program called MassHealth Plus, which requires no co-pays or monthly premiums. To be eligible you must be a resident of the state, a United States citizen and between the ages of 21 and 64.
What Qualifies as Income?
Since MassHealth is designed for low-income residents, it is important that you know exactly what income the program counts, so you can check that figure against the program's income limits. Self-employed individuals will need to use their prior-year tax return, while all other workers will need to add up the wages from their pay stubs, plus tips. Additional income that is counted includes unemployment, Social Security benefits, retirement income, alimony, rental income, capital gains, investment income, and net farming or fishing income.
The application specifically states that applicants do not need to disclose "child support, nontaxable veteran’s payments, Supplemental Security Income (SSI), or most workers’ compensation income."
Identifying Income Limits
MassHealth set different income limits for each of the groups within the program, so you'll need to refer to the income chart on masslegalservices.org to determine whether you qualify. For example, in a family of four, children under the age of 19 are covered if the family income is $3,423 per month or less, while employees of a small business who have a family of four are allowed to make as much as $6,380 a month. Another example would be a single adult between the age of 21 and 64 earning up to $1,397 per month, while a single HIV-positive individual can bring home up to $2,075 and still get the insurance.
Applying for the Program
If you are unsure as to whether you qualify for MassHealth, you can contact a customer service representative with your questions by calling 1-800-841-2900 (TTY 1-800-497-4648). You also can use that number to request an application. Another option is to simply fill out the application on the mahealthconnector.org website and wait for the program administrators to determine whether you meet the income requirements.