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Eligibility Guidelines for MassHealth and Commonwealth Care

How Do I Know Which Program I Might Qualify For?

You'll need to apply to MassHealth to determine whether you qualify for MassHealth or Commonwealth Care. But, before you do, look at the table below. There you'll find some broad guidelines for qualifying for MassHealth and Commonwealth Care. You must meet these AND the program's income guidelines outlined in the income table below.

General Eligibility Guidelines for MassHealth and Commonwealth Care

MassHealth Commonwealth Care

To qualify for any MassHealth program in which BMC HealthNet Plan participates, you must be a Massachusetts resident AND a U.S. citizen, U.S. qualified alien or alien with special status.

You also must meet one or more of the following:

  • Younger than 19
  • Pregnant
  • HIV-positive
  • Disabled
  • A parent living with children under age 19
  • An adult relative living with children for whom you are the primary caretaker
  • Unemployed for a long time
  • Woman under age 65 with breast or cervical cancer

To qualify for any Commonwealth Care program in which BMC HealthNet Plan participates, you must meet all of the following:

  • U.S. citizen or U.S. qualified alien (visit mahealthconnector.org for non-citizen eligibility information)
  • Massachusetts resident
  • 19 years or older
  • Have been uninsured for the last six months*
  • Not eligible for health insurance through Medicaid/Medicare, through your employer, or through your spouse's employer for the last six months*

* Exceptions apply. For example, if your small employer discontinued your group health coverage, MassHealth (the agency that processes applications and determines eligibility for both Commonwealth Care and MassHealth) may waive this six-month wait. Contact MassHealth at 800-841-2900 for more information.

MassHealth and Commonwealth Care Income Guidelines

If your household income is at or below (equal to or less than) the income figure listed for your household size below, you may qualify for affordable health insurance provided by MassHealth or Commonwealth Care. To be eligible, you must also meet the other general guidelines (found in the table above) for these programs.

Note: For certain MassHealth program categories, you may qualify for coverage, despite having a household income that is greater than that listed for your household size below. Visit www.mass.gov/masshealth for more information about income guidelines for various MassHealth programs

Number of Family Members, Including You Monthly Household Income * Yearly Household Income *

1

$2,873

$34,476

2

$3,878

$46,536

3

$4,883

$58,596

4

$5,888

$70,656

5

$6,893

$82,716

If you have more than 5 family members, call MassHealth at 800-841-2900 for more information.

* MassHealth income guidelines are based on monthly household income; Commonwealth Care guidelines are based on yearly income. In general, MassHealth is for Massachusetts residents with low to medium income. The income limits for various MassHealth programs depends on your family size, your category of eligibility, and the type of MassHealth coverage.

You may also find this online resource helpful for learning about health coverage options you might qualify for: www.healthcare.gov

For more information on MassHealth eligibility, please visit www.mass.gov/masshealth. For more information on Commonwealth Care eligibility, please visit the Massachusetts Health Connector site at www.mahealthconnector.org.

How Do I Apply?

Watch our Help Me Apply video that explains in simple steps how to apply to see if you qualify for MassHealth or Commonwealth Care.

Find a place to apply in person.