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Massachusetts Medicaid Laws

The Massachusetts Office of Health and Human Services oversees the state's Medicaid program, called MassHealth. MassHealth provides health coverage to low-income individuals with disabilities, seniors, pregnant women, children and those who are HIV positive. You may apply for MassHealth online or at your local Office of Health and Human Services.

  1. Supplemental Security Income (SSI)

    • If you receive SSI payments from Social Security, you're automatically eligible for MassHealth. If you are not currently receiving MassHealth and you are a Massachusetts resident and receive SSI payments, contact your local Office of Health and Human Services to determine why you are not enrolled in MassHealth.

    Disability

    • You may receive MassHealth based on a disability. If you haven't been found to be disabled by Social Security, MassHealth can make a disability determination. Either Social Security or MassHealth must determine that you're disabled for you to qualify based on disability. A disability is a medical condition that prevents or limits your ability to work for at least 12 months. You may not receive MassHealth based on a short-term disability.

    Income & Resources

    • You must meet income and resource limits to qualify for Medicaid. These limits vary significantly based on several factors, including household size, type of Medicaid, source of income, cost of out-of-pocket medical expenses and other factors. Contact your local Office of Health and Human Services to find out what your exact income and resource limits are based on your circumstances.

    Qualified Medicare Beneficiary (QMB)

    • If you are dual eligible--eligible for both Medicare and Medicaid--the state of Massachusetts may pay your Medicare Part B premiums, co-payments and co-insurance amounts under the Qualified Medicare Beneficiary (QMB) program, a state program under MassHealth. Typically, dual eligibles are auto-enrolled in QMB. If you have both MassHealth and Medicare Part A and B and are not receiving QMB, contact your local Office of Health and Human Services to determine whether or not you qualify for this extra help.

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