Massachusetts MassHealth Medicaid Application Information

Massachusetts provides MassHealth program for its residents. The MassHealth program is a combination of Medicaid and SCHIP. Medicaid deals with elderly and pregnant women while SCHIP deals with children. However, the program usually operates as one and applicants can apply without having to worry about sub-programs. Successful enrollees will be placed in the right category automatically.

Massachusetts MassHealth (Medicaid) provides a comprehensive health insurance plan for pregnant women and elderly. Applicants will only qualify for the program if they have low-income and resources. Moreover, applicants will be required to provide a proof of their identity and income while applying. Applicants will also be required to reside in the state of Massachusetts to get benefits through MassHealth program. U.S citizens and legal aliens can apply for the program.

Once you enroll in the program, you will be able to enjoy various benefits including coverage for dental and medical health, home health services, adult-day health services, personal care attendant program, and transportation services.

In order to enroll, you will be required to complete an application form and submit it to the MassHealth Enrollment Center. You can get the form from the internet or request it to be mailed to. You can call MassHealth Enrollment Center to mail form to your address.

You can also apply in person by visiting your community center. You will get form from the community center and you will be able to get any further information you may need.

MassHealth has different coverage types available to cover all the eligible candidates. However, the coverage type you get will depend on your family situation, income, resources, and health status. Some other factors may also come into play while MassHealth decides coverage type for you. You will have a right to appeal against decisions made by MassHealth related to your coverage and eligibility.

Special Benefits for disabled and elderly

MassHealth provides certain benefits and services for disabled. Through Personal Care Attendant Program (PCA), MassHealth assists people with long-term disability. With the help of funds released through this program, eligible enrollees can hire personal care attendant.

MassHealth also provides funds for nursing care, speech therapy, and physical therapy for its eligible members, including disabled and elderly. These funds are made available to home health agencies, which will decide if the applicant meets requirements to use these Home Health Services or not.

MassHealth program also provides transportation services for all its members, including disabled.

Eligibility Requirements

MassHealth uses state as well as federal rules to determine the eligibility for candidates. Here are some basic rules for determining the eligibility for MassHealth:

  • You can apply for MassHealth (Medicaid) if you are parenting children under 19
  • You can apply if you are a caretaker relative of a child or children under 19. In order to qualify under this category, neither of the parents should be living in the house.
  • Children can apply themselves if they are under 19. Whether they are living with a family or without it, will not affect their eligibility status.
  • Pregnant women can also apply for MassHealth whether they have kids or not
  • You can apply for MassHealth if you are unemployed, risk losing job, or under employed
  • If you are disabled, you can apply for MassHealth
  • People who are HIV positive can also apply for MassHealth
  • Women under the age of 65 and requiring treatment of breast cancer or cervical cancer can also apply for MassHealth

Applicants will have to fall in one of the above-mentioned categories in order to qualify for benefits through MassHealth program. Apart from these general eligibility rules, applicants will also have to be on low income. They will have to be within financial limits set for the program.

Having health insurance already doesn't disqualify you for MassHealth. In some cases, MassHealth will pay a part to cover your private insurance instead of providing you its own insurance plan.

Massachusetts MassHealth Medicaid Application Instructions


Apply by Mail

You can apply by mail after completing the application form for MassHealth. However, you will first have to get an application form. You can get it in two ways:

  • Phone: Call 1 888 665 9997 to reach MassHealth Enrollment Center. You can request more information about the program as well as an application form to be sent to your mailing address.
  • Internet: You can get your application form by downloading it from the internet. You can download application form from MassHealth website.

Once you have the form, you will have to fill out all the five pages and sign the form. You will also be required to send supporting documents along with the form. A proof of your income will also be required by the MassHealth Enrollment Center to ensure that you are stating truth about income and your assets.

Apply in Person

Apply in person: You can apply in person by visiting a community center near you. You will get all the information and application forms from your community center.