Massachusetts Medicaid Financial Guidelines

Massachusetts Medicaid, also known as "MassHealth," provides affordable health care to low income residents. The program encompasses both traditional Medicaid and the Children's Health Insurance Program, each of which are federally and state-funded. In order to qualify for the program, applicants must meet financial eligibility guidelines determined according to the size of their household and family income.

Pregnant Women

• Women with existing pregnancies may qualify for Medicaid with a household income of 200 percent or less of the federal poverty level. Once approved, pregnancy Medicaid covers all prenatal health care and childbirth and also extends benefits to the newborn baby for the first year of the child's life. For example, the 2010 federal poverty guidelines would require that a pregnant woman in a four-person Massachusetts household have a yearly income of $44,100 or less to qualify for Medicaid.

Families with Children

• MassHealth is available to each member of a qualifying family with dependent children under age 19. Caretakers must have a household income that meets or falls below 133 percent of the federal poverty limit for the number of people in their household. The same qualifications apply to disabled individuals in need of Medicaid, though disabled applicants need not have dependent children.

Children

• Under the MassHealth program, children age 1 to 18 have expanded access to Medicaid if their parents cannot qualify for family Medicaid. For children's Medicaid coverage alone, the income cut-off is 133 percent of the federal poverty level. However, the Children's Health Insurance Program, or CHIP, offers affordable health insurance to children of families with household income of up to 300 percent of the federal poverty level. Parents may choose to enroll their children in the Medicaid-funded health insurance program for a premium of $12 per child per month, or opt for employer-based insurance, for which CHIP will pay partial premiums.

Senior Citizens

• Senior citizens over age 65 who apply for Medicaid must not only meet income eligibility requirements, but also asset requirements. The state counts all cash, savings and items of value as assets. The individual asset limit is $2,000 and the couples limit is $3,000 to qualify for Medicaid. However, those with greater assets may qualify for the Medicaid buy-in program with assets up to $6,600 for an individual and $9,910 for a couple. Additionally, seniors over age 65 can only qualify for Medicaid with annual income of 100 percent or less of the federal poverty level.

Income

• For purposes of income, Massachusetts totals the sum of an applicant's earned income, net self-employment profits, Social Security benefits, retirement funds, investment dividends, interest, railroad retirement benefits and rental income to determine Medicaid eligibility. The state excludes some income from consideration, including partial veteran's benefits and non-cash payments.