Massachusetts Medicaid, known as MassHealth, provides health coverage to more than two million residents across the state. Whether you are a working adult, a parent, a senior, or someone with a disability, understanding the eligibility rules for 2026 can help you get the coverage you need. This guide breaks down the income limits, application steps, and key details you should know about MassHealth eligibility this year.
For a quick check on whether you might qualify for MassHealth or other benefit programs, try our free benefits screening tool.
What Is MassHealth?
MassHealth is the name for Medicaid and the Children's Health Insurance Program (CHIP) in Massachusetts. It is jointly funded by the federal government and the state, and administered by the Executive Office of Health and Human Services (EOHHS). MassHealth covers a wide range of services, including doctor visits, hospital care, prescription drugs, mental health treatment, and maternity care.
Massachusetts expanded Medicaid under the Affordable Care Act, which means adults without children can qualify for coverage at higher income levels than in many other states.
Who Qualifies for MassHealth in 2026?
MassHealth serves several groups of residents, each with different income thresholds:
- Adults ages 19 to 64 with income at or below 138% of the Federal Poverty Level (FPL)
- Parents and caretaker relatives with income at or below 138% FPL
- Children under 19 with household income at or below approximately 300% FPL
- Pregnant women with income at or below 200% FPL
- Seniors age 65 and older who meet income and asset requirements
- People with disabilities who meet SSI-related income and asset standards
In all cases, you must be a Massachusetts resident and either a U.S. citizen or have an eligible immigration status.
2026 MassHealth Income Limits
MassHealth uses two systems to determine eligibility. Most working-age adults, children, parents, and pregnant women are evaluated under Modified Adjusted Gross Income (MAGI) rules, which do not include asset tests. Seniors and people with disabilities fall under non-MAGI rules, which include both income and asset limits.
The income limits below are based on the 2025 Federal Poverty Level guidelines, which MassHealth uses until updated FPL figures take effect (typically in March 2026). Once the 2026 FPL is published, limits may increase slightly.
MAGI-Based Programs (Adults, Children, Pregnant Women)
| Eligibility Group | Household of 1 (Monthly) | Household of 2 (Monthly) | Household of 3 (Monthly) | Household of 4 (Monthly) | FPL Standard |
|---|---|---|---|---|---|
| Adults 19 to 64 | approximately $1,732 | approximately $2,351 | approximately $2,970 | approximately $3,588 | 138% FPL |
| Parents/Caretakers | approximately $1,732 | approximately $2,351 | approximately $2,970 | approximately $3,588 | 138% FPL |
| Children under 19 | approximately $3,765 | approximately $5,110 | approximately $6,455 | approximately $7,800 | 300% FPL |
| Pregnant Women | approximately $2,510 | approximately $3,407 | approximately $4,303 | approximately $5,200 | 200% FPL |
Note: These figures include the standard 5% FPL income disregard that MassHealth applies. Actual thresholds may vary slightly. Always confirm current amounts with MassHealth or your local enrollment center.
Non-MAGI Programs (Seniors, People with Disabilities)
| Category | Single Individual (Monthly) | Married Couple (Monthly) | Asset Limit (Single) | Asset Limit (Couple) |
|---|---|---|---|---|
| Regular Medicaid (Aged/Blind/Disabled) | approximately $1,330 | approximately $1,803 | $2,000 | $3,000 |
| HCBS Waivers | $2,982 | $2,982 per spouse | $2,000 | $3,000 |
| Nursing Home Medicaid | No hard income cap* | No hard income cap* | $2,000 | $2,000 per applicant spouse; up to $162,660 for non-applicant spouse |
*For nursing home Medicaid, nearly all monthly income must go toward the cost of care, minus a personal needs allowance of $72.80 per month.
How to Apply for MassHealth: Step by Step
Step 1: Gather Your Information
Before applying, collect the following:
- Social Security numbers for all household members
- Proof of Massachusetts residency (utility bill, lease, or mail)
- Proof of income (pay stubs, tax returns, Social Security award letters)
- Proof of citizenship or immigration status
- Information about any current health insurance
Step 2: Choose Your Application Method
You can apply for MassHealth in several ways:
- Online at mahealthconnector.org
- By phone by calling MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648)
- By mail by downloading an application from mass.gov and mailing it to MassHealth Enrollment Center, P.O. Box 4405, Taunton, MA 02780
- In person at a MassHealth Enrollment Center or with help from a certified application counselor
Step 3: Submit Your Application
Complete all required fields and attach supporting documents. Online applications through the Health Connector are typically the fastest way to get a determination.
Step 4: Wait for a Decision
MassHealth aims to process applications within 30 to 45 days. You may be contacted to provide additional documentation. Keep an eye on your mail and any online account messages.
Step 5: Review Your Determination
If approved, you will receive information about your coverage type and how to select a health plan. If denied, you will receive a written notice explaining the reason and your right to appeal.
What Does MassHealth Cover?
MassHealth provides comprehensive health coverage, including:
- Primary care and specialist visits
- Hospital inpatient and outpatient care
- Prescription medications
- Mental health and substance use disorder services
- Maternity and newborn care
- Preventive care and screenings
- Dental care (for most members)
- Vision care
- Home health services
- Durable medical equipment
Coverage details can vary depending on which MassHealth plan type you are enrolled in (Standard, CarePlus, Family Assistance, etc.).
Important Things to Know for 2026
Annual renewals are required. The temporary pandemic-era continuous coverage protections have ended. MassHealth now conducts regular annual renewals. Watch for a blue envelope or digital notice from MassHealth and respond promptly to avoid losing coverage.
Report changes promptly. If your income, household size, address, or other circumstances change, you must report these changes to MassHealth. Failing to do so can result in a gap in coverage or incorrect benefit levels.
Retroactive coverage is available. MassHealth may cover medical expenses incurred up to three months before your application date, as long as you were eligible during that time.
ConnectorCare changes for 2026. Starting January 1, 2026, ConnectorCare Plan Type 1 has been discontinued for certain non-citizens with income under 100% FPL who are not eligible for MassHealth. If you are affected, review your notice for alternative options or Health Safety Net eligibility.
Federal Medicaid funding changes. The One Big Beautiful Bill Act includes provisions that may reduce enhanced federal Medicaid funding over the coming years. While nursing home care is currently protected, Home and Community Based Services programs could face future adjustments. Check back for updates as federal policy continues to evolve.
MassHealth vs. Health Connector Plans
If your income is too high for MassHealth, you may still qualify for subsidized health insurance through the Massachusetts Health Connector. ConnectorCare plans offer low premiums and reduced cost-sharing for residents with income between 100% and 300% FPL. You can explore your options through the same application at mahealthconnector.org.
Children may still qualify for MassHealth even if their parents earn too much for adult coverage, since children's income limits extend up to approximately 300% FPL.
Frequently Asked Questions
When do the 2026 income limits take effect?
MassHealth typically adopts new Federal Poverty Level guidelines around March 1 each year. Until then, 2025 FPL amounts are used. If you apply early in the year and are denied, it may be worth reapplying after the new guidelines take effect, as the updated limits are usually slightly higher.
Do I need to count assets to qualify?
For most adults, children, parents, and pregnant women, MassHealth does not count assets. Only income matters under the MAGI rules. However, seniors age 65 and older and people with disabilities applying for non-MAGI programs must meet asset limits ($2,000 for individuals, $3,000 for couples as of 2026).
Can I qualify if I am undocumented?
MassHealth Standard is generally available only to U.S. citizens and certain qualified immigrants. However, Massachusetts offers some health coverage options for residents regardless of immigration status, including emergency Medicaid and the Health Safety Net program. Check with a certified application counselor for guidance on your specific situation.
How long does the application process take?
Most MassHealth applications are processed within 30 to 45 days. Online applications through the Health Connector tend to be faster. If additional documentation is needed, the timeline may be extended.
Can MassHealth cover past medical bills?
Yes. If you were eligible during the three months before your application date, MassHealth may provide retroactive coverage for medical expenses incurred during that period.
What if I am denied?
If your application is denied, you have the right to appeal. The denial notice will include instructions on how to request a fair hearing. Many denials result from missing paperwork rather than actual ineligibility, so gathering and submitting complete documentation can often resolve the issue.
Get Started Today
Checking your eligibility for MassHealth takes just a few minutes. Use our free benefits screener to see if you qualify for MassHealth and other assistance programs in Massachusetts. You can also visit our Massachusetts Benefits Overview page for a complete look at all available programs in the state.
If your situation has changed recently due to job loss, a new baby, a change in income, or reaching age 65, now is a great time to check what programs you may be eligible for. Do not leave benefits on the table.
