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MassHealth Guidelines in Massachusetts

MassHealth is a health insurance program offered by the state of Massachusetts to children, pregnant women, unemployed workers and others who can't afford regular medical insurance. Designed for low- and medium-income residents of the state, it provides people with direct health coverage or pays premiums of private health insurance plans.

  1. Income Limits

    • Income limits for MassHealth vary by family size, the type of coverage a family wants and what category of eligibility it falls into. The family's gross monthly income is compared to the federal government's poverty guidelines to come up with a percentage of the federal poverty guidelines. To qualify, income has to be equal or less than the state-specified limit. For instance, a family of four seeking coverage for minors in the family can make no more than $2,794 gross per month as of 2011, which is 150 percent of the federal poverty guidelines. A detailed income chart is available on the MassResources website.

    Asset Limits

    • Assets include savings and property of value. For most, though not all, applicants under 65, MassHealth imposes no asset limits. For those 65 and over, countable assets -- which include second vehicles, real estate not used as a primary residence, pensions, retirement accounts and bank account balances -- must not exceed $2,000 for a single person or $3,000 for a couple applying for standard, essential or limited MassHealth coverage. If applying for MassHealth buy-in, assets can't exceed $6,680 for a single person or $10,020 for a couple.

    Family Size

    • Members of your immediate family, or extended family members who live with you, including any children under the age of 19 and their parents, count in MassHealth's determination of family size. Pregnant women count as two people because the unborn child is counted individually.

    Continued Eligibility

    • You must continue to meet eligibility requirements to continue receiving the insurance benefit. Thus, any changes that could affect your eligibility, such as changes in assets and income and family size, must be promptly reported to the state.

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