How long can you stay on MassHealth?

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MassHealth coverage lasts for as long as you remain eligible, with reviews typically happening once a year (or every 12 months) through an annual renewal process.

Key Coverage Durations

  • Children and Young Adults: Members under 19 years old get 12 months of continuous coverage, meaning they keep their benefits for a full year even if family income changes. After that, it lasts as long as they stay eligible.
  • Adults and General Members: Coverage continues year-to-year as long as you complete your annual renewal and continue to meet the income and rules for MassHealth.

How Renewals Work

  • MassHealth checks your eligibility at least once a year.
  • Some groups or low-income adults may have reviews more frequently or can be auto-renewed if MassHealth has enough current data.
  • You will get a notice (often in a blue envelope) telling you if you need to take action to keep your insurance. You must reply by the due date on the notice to avoid losing benefits.
  • You can manage or update your details via the MassHealth Renewal Guide or by calling customer service at 1-800-841-2900.

What is the income limit for MassHealth in 2026?

For most adults aged 19 to 64, the 2026 MassHealth income limit is 133% of the Federal Poverty Level (FPL), which is approximately $1,769 per month ($21,228 per year) for a single person effective March 1, 2026.

2026 MassHealth Income Limits by Household Size

MassHealth limits vary depending on your household size and the specific coverage category. Based on the 2026 MassHealth Income Standards and Federal Poverty Guidelines effective March 1, 2026, the monthly limits for 133% FPL (standard adult expansion) are:

  • Household of 1: $1,769 per month ($21,228/year)
  • Household of 2: $2,399 per month ($28,788/year)
  • Household of 3: $3,028 per month ($36,336/year)
  • Household of 4: $3,658 per month ($43,896/year)

Limits by Category

  • Children (0–19): Qualify up to higher thresholds (around 300% FPL, or ~$3,990/month for a household of two).
  • Pregnant Women: Qualify up to 200% FPL (~$2,605/month for a household of two).
  • People with Disabilities (CommonHealth): Has no income cap, though members earning above 150% FPL may have a sliding-scale monthly premium.
  • Seniors (65+): Community standard limits generally look at 100% FPL ($1,330/month for a single person), but higher medical expenses can qualify you via a medically-needy spend-down.

Note that MassHealth applies a 5% FPL income disregard when calculating your total countable household income. You can review detailed charts through the Federal Poverty Level Guidelines.

What are the new rules for MassHealth?

Major new federal rules and eligibility changes are taking effect for MassHealth (Massachusetts Medicaid) under the federal One Big Beautiful Bill Act.

Immediate Changes (Fall 2026)

  • Immigrant Eligibility Changes (October 1, 2026): Federal rules narrowed comprehensive Medicaid eligibility for certain lawfully present immigrants, including certain refugees, asylees, and humanitarian parolees. Affected individuals are notified directly by the state.
  • Dental Coverage Limit (Started August 1, 2026): An annual cap of $1,750 was implemented for routine dental services for MassHealth members aged 21 and older (with exemptions for clients of the Department of Developmental Services and members under 21).
  • Anti-Obesity Medications (Started July 3, 2026): MassHealth stopped covering anti-obesity drugs (such as Wegovy or Zepbound) when prescribed exclusively for weight loss, unless specific severe secondary medical criteria are met.

Upcoming Changes (January 1, 2027)

  • Work and Education Requirements: Adults aged 19 through 64 who do not qualify for an exemption must complete at least 80 hours per month of work, volunteering, job training, or school (or earn a minimum of $580 monthly) to maintain benefits.
  • Exemptions from Work Rules: Exemptions apply to individuals with disabilities, pregnant individuals, parents or caregivers of children age 13 or younger, individuals over 64 or under 19, and those medically frail due to severe health or behavioral conditions.
  • More Frequent Renewals: Many expansion adult members will shift to mandatory eligibility renewals every six months instead of annually.
  • Shorter Retroactive Coverage: Retroactive coverage windows will shrink to one month for certain adults and two months for other groups.

What You Should Do

  • Update Contact Information: Ensure MassHealth has your correct mailing address, phone number, and email.
  • Watch for the Blue Envelope: Renewal notices and requests for information arrive via mail in blue envelopes. Open and respond to them immediately.
  • Check Status: You can review official notices and details through the MassHealth Federal Updates and Impact portal or call MassHealth directly at 1-800-841-2900.

How much income can you keep from MassHealth?

How much income you can keep from MassHealth depends on whether you live in the community or reside in a long-term care facility.

Living in the Community

If you live at home, your allowed income depends on your household size and the specific MassHealth program.

  • Seniors (65+): The 2026 income limit for MassHealth Standard is generally 100% of the federal poverty level, which is $1,330 per month for a single person and $1,804 per month for a two-person household.
  • Medically Needy / Spend-down: If your income is higher than the limit, you may still qualify by "spending down" excess income on incurred medical bills.
  • Medicare Savings Programs: Income limits range higher (up to 225% of the federal poverty level) with no asset test.

Residing in a Long-Term Care Facility

If you live in a nursing home, MassHealth requires you to put almost all your monthly income toward the cost of your care, but you are allowed to keep a specific set-aside amount:

  • Personal Needs Allowance (PNA): You can keep $72.80 per month for personal incidental expenses.
  • Health Insurance: You can deduct amounts paid directly for supplemental health insurance premiums.
  • Spousal Income (MMMNA): If you have a spouse living at home (a community spouse), a portion of your income can be diverted to them under the Monthly Maintenance Needs Allowance, which ranges from a minimum of $2,705.00 up to $4,066.50 per month in 2026.

You can review official guidelines and download the full breakdown through the 2026 MassHealth Income Standards and Federal Poverty Guidelines.

What happens to MassHealth when you turn 65?

When you turn 65, MassHealth requires you to enroll in Medicare if you qualify, and it begins evaluating your savings and assets under new senior rules.

Mandatory Medicare Enrollment

  • Primary Coverage: MassHealth acts as the payer of last resort. If you are 65 or older and have MassHealth Standard with an income at or below 190% of the federal poverty level, you must enroll in Medicare.
  • Staying Eligible: You must sign up for Medicare Parts A and B when you become eligible. If you fail to enroll, you can lose your MassHealth benefits.
  • Exceptions: If you are not eligible for Medicare, you will not lose your MassHealth coverage.

New Asset and Income Limits

  • Asset Limit: Unlike younger adults who do not face a general asset limit, members aged 65 and older are restricted to a $2,000 asset limit for an individual. MassHealth looks at your savings accounts and other countable resources.
  • Income Limits: Your monthly income is re-evaluated using specific senior financial guidelines. If your income is slightly too high for standard coverage, alternative programs like the Senior Buy-In can help pay for Medicare costs.

What You Need to Do

  • Apply Early: Apply for Medicare a few months before your 65th birthday to avoid gaps in coverage and late penalties.
  • Submit Forms: MassHealth may require you to complete a senior application, such as form SACA-2, to update your eligibility category.
  • Get Help: You can call MassHealth customer service or contact your local aging access center for help with the transition.

What to know and how to stay covered as MassHealth begins its first patient audit in three years

9 related questions found

Does MassHealth look at your bank account?

MassHealth does look at your bank account depending on your age and the specific type of coverage you need.

When MassHealth Checks Bank Accounts

  • Long-Term Care and Age 65+: If you apply for long-term care or are 65 or older, MassHealth checks your bank statements and assets. Single applicants can only have $2,000 in countable assets, like savings and checking accounts.
  • The 5-Year Look-Back: For long-term care, MassHealth uses a 5-year (60-month) look-back period. They review your financial records for the prior five years to see if you gave away money or sold assets below market value.
  • Under Age 65 and Non-Long-Term Care: For regular MAGI-based MassHealth (for most children, parents, and non-disabled adults under 65), eligibility is based on income rather than assets. They generally do not look at your accumulated savings or bank account balances.

What is the most money you can make and still qualify for Medicaid?

For most adults aged 19 to 64 in expansion states, the maximum income to qualify for Medicaid is 138% of the federal poverty level, which is about $20,120 per year for a single adult in 2026.

The exact income limit changes depending on your state, household size, age, and health situation.

Income Limits by Group

  • Expansion Adults: 138% of the federal poverty level (FPL) for adults under age 65 in the 40 expansion states plus Washington, D.C. Non-expansion states often do not cover non-disabled, childless adults regardless of income.
  • Children and Pregnant Women: Higher limits apply, often ranging from 200% to over 300% of the FPL depending on the state and program rules like the Children's Health Insurance Program (CHIP).
  • Aged, Blind, and Disabled: Limits are often tied to Supplemental Security Income (SSI) levels or higher caps for long-term care, which is around $2,982 per month for specific programs in 2026. You can use the Medicaid Eligibility Calculator to see general thresholds.

How much money can you have in the bank and still get MassHealth?

How much money you can have in the bank for MassHealth (Massachusetts Medicaid) depends entirely on your age and the specific program you are applying for.

1. If You Are Under Age 65

If you are between the ages of 19 and 64, there is no asset limit for the primary MassHealth programs (such as MassHealth Standard under the Affordable Care Act expansion).

  • Bank account limit: Unlimited. MassHealth does not look at your savings, bank accounts, or investments.
  • How you qualify: Eligibility is based strictly on your monthly household income (which must generally be at or below 138% of the Federal Poverty Level).

2. If You Are Age 65 or Older (or Need Long-Term Care)

Once you turn 65, or if you require nursing home or long-term care at any age, MassHealth enforces strict asset limits. In this tier, your bank accounts (checking, savings, CDs) count toward your total limit.

Your Living Situation2026 Countable Asset Limit
Single Individual (Living at home or in a nursing home)$2,000
Married Couple (Both spouses applying)$3,000 combined
Married Couple (Only one spouse needs long-term care)$2,000 for the applicant spouse;
Up to $162,660 for the "community spouse" staying at home.

What is considered an "Exempt" (Non-Countable) Asset?

If you are over 65, you can still qualify for MassHealth if you have more than $2,000 in overall net worth, provided that money is tied up in exempt assets rather than a standard bank account. Exempt items include:

  • Primary Home: Exempt up to an equity value of $1,130,000 if you or certain qualified family members reside there.
  • Vehicle: One primary vehicle of any value is completely exempt.
  • Burial Account: You are allowed to have a separate, designated bank account containing up to $1,500 specifically set aside for funeral or burial expenses.
  • Prepaid Funeral Plans: Irrevocable prepaid funeral contracts or trusts are fully exempt.

What if you have too much money in the bank?

If your savings exceed the limit, you cannot simply give your money away to family members to qualify. MassHealth uses a strict 5-year (60-month) look-back period. Any assets gifted or sold below market value within those 5 years will trigger an eligibility penalty period.

Instead, seniors often utilize an official MassHealth Spend Down. This allows you to legitimately reduce your bank account balances by paying off outstanding debt, buying a prepaid funeral plot, making necessary home repairs, or paying for immediate medical bills until your countable balance drops below the threshold.

Can MassHealth take your home?

Yes, MassHealth can potentially claim your house after your death or place a lien on it under certain circumstances.

How MassHealth Claims a House

  • Estate Recovery: Under the Massachusetts Medicaid Estate Recovery program, the state seeks repayment for care costs from a member’s probate estate after they pass away. If the home is in your sole name and goes through probate, it can be used to pay back the state.
  • Lifetime Liens: MassHealth can place a lien on your home while you are alive if you move permanently to a nursing facility and no protected relative (like a spouse or disabled child) lives there. This lien secures repayment if the house is sold during your lifetime.
  • Who is Affected: Recovery generally applies to members who received long-term care at any age, or any medical services if the member was 55 or older when they received them.

When MassHealth Cannot Take the House

  • Protected Family Members: The state will not force the sale of a home or pursue recovery if a spouse, a minor child under 21, or a permanently disabled or blind child lives in the house.
  • Non-Probate Assets: Massachusetts limits estate recovery to assets that pass through probate. Proper planning tools—such as certain irrevocable trusts or life estates—can keep a home out of your probate estate and protect it from recovery.
  • Low-Value Estates: MassHealth generally does not pursue recovery if the total probate estate is valued at less than $25,000.

What makes you eligible for MassHealth?

You are eligible for MassHealth if you meet specific rules for state residency, income, household size, and citizenship or immigration status.

Core Requirements

  • Residency: You must live in Massachusetts and plan to stay, or have a job commitment there.
  • Citizenship: You must be a U.S. citizen or have a verified, satisfactory immigration status.
  • Application: You must complete an official application to let the state check your details.

Financial Rules

  • Under Age 65: Eligibility depends mostly on your household size and your Modified Adjusted Gross Income (MAGI).
  • Age 65 and Older: Eligibility depends on both your income and your countable assets, such as bank accounts. The asset limit for a single individual is typically $2,000.

Special Groups

  • Coverage Categories: You may qualify based on age, pregnancy, having a disability, or being the primary caretaker of a child.
  • Work Requirements: Starting in 2027, certain members aged 19 to 64 must meet work, education, or volunteer hours to keep their coverage, unless they qualify for an exemption like a disability or being a primary caregiver.