Massachusetts Medicaid Information

Medicaid is a national health insurance program for low-income individuals. In Massachusetts, both Medicaid and the Children's Health Insurance Program are called MassHealth. People who qualify for one of the MassHealth programs have access to numerous health care services at low cost. Many senior citizens who need help affording long-term care also get assistance from MassHealth.

Eligibility

• To be eligible for MassHealth, you must fall into one of several categories. Pregnant women, the disabled, seniors aged 65 or older, women with breast or cervical cancer, individuals who are HIV-positive and families or adult caretakers with children under 19 years old all potentially qualify. You must also be a resident of Massachusetts, although there is no minimum length of time you must have lived in the state.

Financial Requirements

• Most families who apply for MassHealth do not have to submit to an asset test. However, people aged 65 or over who need for institution care must not exceed an asset limit. In 2011, the countable asset limit was $2,000 for a single person or $3,000 for a couple. Countable assets include all vehicles except one, cash, pensions, retirement accounts, annuities, bank accounts and all real estate except your house. Assets which are not counted are your home, one car, funeral or burial arrangements and the assets of anyone receiving Supplemental Security income. Your monthly income also helps determine if you qualify for Medicaid. Pregnant women cannot have a monthly income of more than 200 percent of the federal poverty guidelines, while people 65 or older cannot exceed 100 percent of the FPG.

Coverage Types

• Massachusetts has several different kinds of Medicaid programs, serving different populations. MassHealth Basic is for people who receive Emergency Aid to Elders, Disabled and Children benefits, as well as low-income clients of the Department of Mental Health. MassHealth Standard can be used by parents with minor children, pregnant women, children up to 19 years, women with cervical or breast cancer, seniors and the disabled. The Medicare Buy-In Program is for dual-eligible Medicare beneficiaries, seniors who qualify for both Medicare and Medicaid who need paying Medicare expenses.

Benefits

• The specific benefits you get through MassHealth depend on which program you qualify for. In general, most plans include rehabilitation services, long-term care, inpatient hospital care, doctor's office visits, family planning, dental services, home health, hospice care and medical tests. Only MassHealth Standard offers long-term nursing home care. All MassHealth plans cover emergency ambulance transportation.