MassHealth, otherwise known as Medicaid, is a government health insurance program that helps people in Massachusetts with low income get health care services at a lower cost. There are several different MassHealth programs, each serving a different group of people.

Apply for MassHealth Online

What does MassHealth cover?

MassHealth pays for routine and acute health care services. This includes:

• Visits to health care providers (including physicians and nurse practitioners)
• Inpatient and outpatient hospital services
• Early and periodic screening, diagnostic, and treatment services
• Preventive care (e.g., vaccinations)
• Lab tests and X-rays
• Dialysis services
• Mental health services
• Substance use treatment
• Rural health clinic services
• Medical transportation
• Long-term care (e.g., nursing facility care, home health services)

MassHealth may also cover services such as:

• Physical, respiratory, and occupational therapy
• Home- and community-based care
• Smoking cessation services
• Prescription drugs
• Dental and vision care

Since the program serves those with limited income and resources, people with MassHealth pay few to no out-of-pocket costs. To get coverage once you are enrolled, you must go to health care providers that take part in the MassHealth program.

MassHealth is administered by the Executive Office of Health and Human Services (EOHHS) through its Office of Medicaid. Call the MassHealth Customer Service Center at 1-800-841-2900 (TDD/TTY: 711) to learn more about the coverages provided.

How do I know if I qualify for MassHealth?

In general, to be eligible for MassHealth, you must:

• Be a Massachusetts resident
• Be a U.S. citizen or a qualified non-citizen
• Meet specific income and (if applicable) asset limits

If you need help with your health care coverage and costs, you should apply for MassHealth even if you think you are over the income limit or your assets are too high. This is because:

• Not all types of income are counted toward the income limit.
• You may qualify for a different form of assistance paying for health care. For example, if you have Medicare, you may qualify for a Medicare Savings Program.

What are the different MassHealth programs?

You may be able to get health coverage if you fall into one of the following categories:

MassHealth Standard Program

You may qualify for MassHealth Standard if you are an adult age 65+, you are under age 65 and you have a disability, or you are in another group of people who can get help (e.g., those with certain medical conditions).

MassHealth CarePlus Program (Expanded Medicaid)

The MassHealth CarePlus program provides low-cost health insurance for people who cannot get coverage through regular MassHealth or private insurance. You may be able to get help from this program if you live in Massachusetts, have limited income, and are between 19 and 64 years of age.

MassHealth CommonHealth

MassHealth CommonHealth is a Medicaid program for people with disabilities whose income is too high to qualify for MassHealth Standard. It is available to both adults and children with disabilities, regardless of whether they work. You may have to pay a monthly premium based on your income, but you receive the same benefits as other MassHealth members.

Medically Needy Program (MassHealth Spend-Down)

The Medically Needy program, also called the MassHealth (Medicaid) Spend-Down program, lets you get MassHealth benefits even if your income is higher than MassHealth guidelines. It works by letting you spend down your income so that you meet MassHealth income limits. You may get help from the Spend-Down program if you have limited income and resources.

How do Medicare and MassHealth work together?

MassHealth pays for some services not covered by Medicare. If you get Medicare, you may also be able to get additional help from MassHealth (Medicaid). Millions of Americans have both Medicare and Medicaid coverage. This is called being "dual eligible."

If you have Medicare and qualify for full MassHealth coverage, the state will pay your Medicare Part B (Medical Insurance) monthly premiums. Depending on the MassHealth program you qualify for, the state might also pay for:

• Your share of Medicare costs, like deductibles, coinsurance, and copayments
• Part A (Hospital Insurance) premiums, if you have to pay a premium for that coverage
• If you have both Medicare and MassHealth, you should show both cards to your health care provider each time you receive services.

In addition, if you are dual-eligible for Medicare and MassHealth:

• You will automatically be signed up for the Low-Income Subsidy (LIS)/Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.
• You can get your coverage through a Medicare Advantage Special Needs Plan (SNP) instead of having original Medicare with separate Medicaid coverage. This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

Note: SNPs are not available in every community. To find out if there is an SNP in your area, visit the Medicare website or call 1-800-633-4227 or 1-877-486-2048 (TTY).

How do I prepare to apply for MassHealth?

When you apply for MassHealth, you’ll be asked for important information to help determine if you qualify for benefits. Before you start, gather some basic information to make your application process easier: 

• A document that shows your age, such as your birth certificate or driver’s license
• Your Social Security card
• Pay stubs for anyone in your household who has earned income
• Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)
• Information about your financial assets, such as bank account or investment account statements
• Information about any health-insurance that you already have or have access to

How do I apply for MassHealth?

There are a few different ways you can apply for MassHealth, depending on your age and your preferences.

If you are over 65, you should use the Application for Health Coverage for Seniors and People Needing Long-Term Care Services. You can submit the application in the following ways:

• Online: Complete the PDF application form online or print it out and complete the paper version.
• By Mail: Send your completed application and any required documents to:

MassHealth Enrollment Center
P.O. Box 290794
Charlestown, MA 02129

• By Fax: Fax your completed application and any required documents to 1-617-887-8799.

If you are under 65, you should use the Massachusetts Application for Health and Dental Coverage and Help Paying Costs (also available in large print and in Spanish). You can submit the application in the following ways: 

• Online: Create a new account and apply online at Mass.gov.
• By Mail: Download the application (Spanish version, Large-Print version), print it out, and mail it along with required documents to:

Health Insurance Processing Center
PO Box 4405
Taunton, MA 02780

• By Fax: Fax your completed application and any required documents to 1-857-323-8300
• By Phone: Call the MassHealth Customer Service Center at:

1-800 841-2900 (TDD/TTY: 711)
Hours: Monday through Friday 8 a.m. to 5 p.m.

How can I get help with my application?

• Make an appointment with a MassHealth enrollment specialist.
• Call the MassHealth Customer Service Center at 1-800 841-2900
• Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.
• NCOA also has a HelpLine you can call to get free support. To get started today, call 1-800-794-6559.