Medicaid Eligibility in Massachusetts: Income Limits & How to Apply

Medicaid Eligibility in Massachusetts

Massachusetts expanded its Medicaid program under the Affordable Care Act, opening MassHealth to adults aged 19-64 whose income falls at or below 138% of the federal poverty level. In 2026, that works out to roughly $21,597 for one person or $44,367 for a family of four.

MassHealth provides coverage to the following groups:

• Adults aged 19-64 with income up to 138% FPL
• Children in families with income up to 200-300% FPL (varies by age)
• Pregnant women with income up to 185-200% FPL
• Seniors and people with disabilities who meet income and asset requirements

About MassHealth

In Massachusetts, MassHealth is the state's Medicaid program, providing free or low-cost health coverage to eligible residents. You may qualify for MassHealth if your household income is at or below 138% of the Federal Poverty Level (FPL). For example, as of March 1, 2026, an individual earning up to $21,228 annually, or a family of three with an income up to $36,336 annually, would generally be eligible. Higher income limits apply for specific groups; for instance, pregnant individuals and children under one year old may qualify with household incomes up to 200% FPL, while children ages 1-18 may qualify up to 300% FPL. MassHealth also covers seniors and people with disabilities, often with different income and asset rules. This is a substantial program, with about 2 million Massachusetts residents covered by Medicaid/CHIP as of May 2024, demonstrating its widespread use and importance.

If your income is slightly above the MassHealth cutoff, you might transition to subsidized coverage through the Massachusetts Health Connector, the state's health insurance marketplace. Massachusetts has a robust marketplace with a benchmark Silver plan costing around $436 per month, which is lower than the national average. If you qualify for ConnectorCare plans, you could see significantly reduced or even no premiums and no deductibles, as Massachusetts expanded eligibility for these state-subsidized plans to those with incomes up to 500% FPL, a pilot program effective January 1, 2024. For an individual, this means an income up to $72,900 in 2024, or $150,000 for a family of four. If your income changes, you could shift between MassHealth and marketplace subsidies, so it's important to report any income fluctuations to ensure you remain in the correct program. After the federal continuous coverage requirement ended, many people lost MassHealth coverage during redeterminations, but you can reapply if your circumstances change.

MassHealth provides comprehensive benefits, typically covering doctor's visits, hospital care, prescription medications, mental health services, dental care, and vision care, often with little to no cost-sharing for eligible members. For those needing long-term care, MassHealth has specific programs and waivers. For example, the Frail Elder Waiver offers home and community-based services to help seniors avoid nursing home placement. Massachusetts also has unique initiatives, like the 1115 Medicaid waiver, which focuses on health equity and ties hospital financial incentives to reducing health disparities. Additionally, a new Complex Care Assistant provider type allows parents or guardians to be paid for caring for their children with complex needs, including some enhanced medical services.

Be aware that while many MassHealth programs do not have asset limits, some, particularly for long-term care services, do. For example, a single applicant for Nursing Home Medicaid in 2026 generally has an asset limit of $2,000, though your primary home and one vehicle are typically excluded. You'll need to provide documentation of your assets and income during the application process. MassHealth has generally maintained telehealth flexibilities, allowing for various services to be delivered remotely, which can improve access to care. However, federal changes, such as the "One Big Beautiful Bill Act" passed in 2025, will bring new rules to MassHealth, including potential work or education requirements and more frequent renewals for some members starting in 2027. To ensure you have the most up-to-date information and understand your specific eligibility, your best action step is to contact a MassHealth Enrollment Center directly.

Massachusetts Medicaid Income Limits 2026

The following table shows the key income thresholds for Massachusetts in 2026:

If your household income falls below the 138% FPL column, you qualify for MassHealth. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.

At $436/month for a benchmark Silver plan, Massachusetts has some of the more affordable marketplace premiums in the country. Residents just above the Medicaid threshold often pay very little out of pocket after subsidies.

Marketplace Insurance in Massachusetts

Massachusetts residents who do not qualify for Medicaid can purchase private health insurance through Massachusetts Health Connector. The average benchmark (second-lowest cost Silver) plan in Massachusetts costs approximately $436/month for a 40-year-old in 2026.

Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Massachusetts might pay after subsidies:

These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.

Unlike most states, Massachusetts runs its own insurance marketplace through Massachusetts Health Connector. Residents shop for plans and apply for subsidies through this state-run platform rather than HealthCare.gov.

As an expansion state with its own marketplace infrastructure, Massachusetts demonstrates strong commitment to coverage. MassHealth benefits tend to be generous, and the enrollment process is well-integrated between Medicaid and marketplace plans.

How to Apply for MassHealth

1. Start online at Massachusetts Health Connector — the application automatically screens for MassHealth eligibility based on your household income.
2. Go through the state directly — Massachusetts's Medicaid office accepts applications year-round with no enrollment window.
3. Get phone support — Massachusetts's Medicaid hotline can walk you through the process and verify eligibility.
4. In-person options — Local social services offices and community health navigators can assist with your application.

Have the following ready: recent pay stubs or tax returns, proof that you live in Massachusetts, Social Security numbers for everyone in your household, and details on any existing health insurance.

Frequently Asked Questions

Medicaid Eligibility in Nearby States