What is the income limit for MassHealth in 2026?
The maximum income limit to qualify for standard adult MassHealth (CarePlus) is 138% of the Federal Poverty Level (FPL), which equals approximately $1,800 per month ($21,595 per year) for a single person in 2026.
MassHealth 2026 Income Limits by Household Size
Limits vary depending on your specific category (such as adults, pregnant individuals, or children) and are tied to the Federal Poverty Guidelines:
- Adults (138% FPL - CarePlus):
- 1 person: ~$1,800/month ($21,595/year)
- 2 people: ~$2,432/month ($29,189/year)
- 4 people: ~$3,697/month ($44,368/year)
- Pregnant Individuals & Infants (up to 200% FPL):
- 1 person: $2,660/month
- 4 people: $5,500/month
- Children (ages 1–18, up to 150% FPL): Higher thresholds apply depending on the exact age and household tier.
- CommonHealth (for individuals with disabilities): Has no income ceiling or cap, though higher-income members may have a sliding-scale monthly premium.
You can check your eligibility or apply directly through the Massachusetts Health Connector.
How much money can I make and still be on MassHealth?
The amount of money you can make and still qualify for MassHealth (Massachusetts Medicaid) depends entirely on your age, household size, and disability status. MassHealth measures income thresholds using the Federal Poverty Level (FPL).
1. General Adults (Ages 19–64)
For standard adults without minor children or a disability, eligibility is capped at 138% of the FPL.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 Person | ~$1,835 / month | $22,025 / year |
| 2 People | ~$2,489 / month | $29,863 / year |
| 3 People | ~$3,143 / month | $37,702 / year |
| 4 People | ~$3,795 / month | $45,540 / year |
2. Adults with Disabilities (MassHealth CommonHealth)
If you meet the state's criteria for a disability, Massachusetts offers a unique program called MassHealth CommonHealth. There is no upper income limit and no asset limit for this program. If your income is below 150% of the FPL, your coverage is free. If you make more, you simply pay a sliding-scale monthly premium to keep full MassHealth coverage.
3. Seniors (Ages 65 and Older)
For seniors living in the community, the limit for full coverage (MassHealth Standard) is stricter, set at 100% of the FPL. Seniors are also subject to an asset limit of $2,000 for an individual or $3,000 for a couple.
- Single Senior: Limit is $1,330 / month.
- Married Senior Couple: Limit is $1,804 / month.
4. Children and Pregnant Individuals
MassHealth allows for much higher household income thresholds for these groups:
- Pregnant Individuals: Up to 200% FPL (~$2,660/month for a single person).
- Children (under 19): Up to 300% FPL (~$3,990/month for a household of two).
What if I make too much money?
If your income slightly exceeds the limits for standard MassHealth, you are automatically evaluated for ConnectorCare through the Massachusetts Health Connector. ConnectorCare offers highly subsidized private insurance plans with $0 or very low monthly premiums for individuals making up to 500% FPL (about $79,800/year for an individual).
What is the maximum income to qualify for medical in 2026?
For most adults in expansion states like California (where Medicaid is known as Medi-Cal), the maximum income to qualify for Medi-Cal in 2026 is 138% of the Federal Poverty Level (FPL).
2026 Income Limits for Medi-Cal (138% FPL)
- Household of 1: $22,025 per year (approx. $1,835/month)
- Household of 2: $29,863 per year (approx. $2,489/month)
- Household of 3: $37,702 per year (approx. $3,142/month)
- Household of 4: $45,540 per year (approx. $3,795/month)
Note: Medicaid rules, names (like Medi-Cal), and specific caps vary by state, and different limits apply to children (often up to 266% FPL) or pregnant individuals (up to 213% FPL).
What makes you qualify for MassHealth?
To qualify for MassHealth, you must live in Massachusetts, meet specific income and asset limits, and have verified citizenship or an eligible immigration status.
Basic Requirements
- Residency: You must live in Massachusetts and intend to stay there, have a job commitment, or be actively looking for work.
- Citizenship or Immigration: You must be a U.S. citizen or hold a satisfactory immigration status.
- Application: You must complete an official application to determine which category fits your situation.
Income and Age Rules
- Adults Under 65: Financial eligibility is based primarily on your household income and size. Adults generally qualify if household income is at or below 138% of the federal poverty level.
- Children: Children and pregnant individuals often qualify with higher income limits, sometimes up to 300% of the federal poverty level depending on household size.
- Adults 65 and Older: Eligibility for older adults reviews both income and countable assets (such as bank accounts and property), with single applicants typically limited to $2,000 in assets.
Special Categories
- Disabilities: Individuals with a qualifying disability may get coverage at higher income levels, though some tiers require a monthly premium.
- Work Requirements: Certain members aged 19 to 64 must meet specific work, education, or community engagement hours to maintain their benefits.
Does MassHealth check your income?
Yes, MassHealth checks your income to decide if you qualify for health benefits.
How MassHealth Checks Income
- Electronic verification: The application system checks federal and state data sources, including IRS tax records and wage databases, to match the income you report.
- Income calculation: MassHealth uses your Modified Adjusted Gross Income (MAGI), which counts your total household earnings and allows certain tax deductions.
- Proof requests: If the system cannot automatically verify your details, or if your numbers do not match electronic records, MassHealth asks you to send proof.
Accepted Income Proof
- Recent pay stubs (such as your last 30 days of pay).
- Tax returns or W-2 forms.
- Records of unearned income, like Social Security, pensions, or unemployment.
- A signed zero-income affidavit if you have no money coming in.
What's New in Massachusetts Medicaid 2026? Income Limits & Requirements | Complete Breakdown
What are the MassHealth income limits for 2026?
MassHealth income limits for adults (aged 19–64) are set at 138% of the Federal Poverty Level (FPL), effective March 1, 2026.
2026 Yearly Income Limits (138% FPL)
- Household of 1: $22,025 per year ($1,835/month)
- Household of 2: $29,863 per year ($2,489/month)
- Household of 3: $37,702 per year ($3,142/month)
- Household of 4: $45,540 per year ($3,795/month)
Limits by Program and Household
- 100% FPL (Seniors 65+ / Disabled): $1,330 per month ($15,960 yearly) for an individual; $1,804 per month ($21,648 yearly) for a couple.
- Children and Pregnant Individuals: Qualify at higher thresholds, often ranging from 155% up to 300% of the FPL depending on age and category.
- CommonHealth: Offers coverage for working or non-working individuals with disabilities with no income ceiling (though higher earners pay a sliding-scale premium).
You can check complete program charts and details directly using the 2026 MassHealth Income Standards Document.
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.
Can I get Medicaid if I'm unemployed?
Yes, you can qualify for Medicaid if you are unemployed, because eligibility depends primarily on your household income and size rather than whether you have a job.
How Eligibility Works
- Income Limits: Medicaid is designed for people with low incomes. If you have no job and little to no income, you are much more likely to meet the financial limits.
- State Rules: Rules change depending on the state where you live. States that expanded Medicaid under the Affordable Care Act allow most low-income adults to qualify regardless of whether they have children. Non-expansion states have stricter limits that usually require you to be a parent, pregnant, elderly, or disabled.
- Unemployment Benefits: If you receive unemployment insurance, that money counts as income, but your total amount may still fall below the limit.
How to Apply
- You can apply at any time of the year.
- Visit HealthCare.gov to submit an application, and your information will go to your state agency if you qualify.
- You can also contact your local state Medicaid office directly.
What is the federal poverty level for 2026?
The 2026 Federal Poverty Guidelines set 100% of the federal poverty level at $15,960 for an individual and $33,000 for a family of four in the 48 contiguous states and Washington, D.C.
📊 2026 Federal Poverty Guidelines (100% FPL)
- 48 Contiguous States & D.C.:
- Size 1: $15,960 annual ($1,330 monthly)
- Size 2: $21,640 annual ($1,803 monthly)
- Size 3: $27,320 annual ($2,277 monthly)
- Size 4: $33,000 annual ($2,750 monthly)
- Each additional person: Add $5,680 annual ($473 monthly)
- Alaska:
- Size 1: $19,950 annual ($1,663 monthly)
- Size 4: $41,250 annual ($3,438 monthly)
- Hawaii:
- Size 1: $18,360 annual ($1,530 monthly)
- Size 4: $37,950 annual ($3,163 monthly)
✅ Program Eligibility Thresholds
- Medicaid Expansion: Typically available under 138% of the FPL.
- Marketplace Subsidies: Available for households earning between 100% and 400% of the FPL.
- Higher Multiples: Many assistance programs scale guidelines up to 150%, 200%, or 250% of these base figures.
How much income can you have and still get Medicare?
You can have any amount of income and still get standard Medicare eligibility.
Eligibility Basics
- No Income Cap: There is no income limit to qualify for Medicare Part A and Part B if you are 65 or older or qualify due to a disability.
- High Earners: You cannot make too much money to enroll, but higher earnings will increase your monthly costs.
How Income Affects Costs (IRMAA)
- Standard Thresholds: If your modified adjusted gross income (MAGI) is $109,000 or less for single filers ($218,000 or less for joint filers), you pay the standard Part B premium.
- Surcharges (IRMAA): If your income exceeds those thresholds, you pay an extra charge called the Income-Related Monthly Adjustment Amount for Part B and Part D.
- Maximum Rates: Surcharges scale up based on tax returns from two years prior, reaching up to $689.90 per month for individuals earning $500,000 or more.
Low-Income Assistance
- Medicare Savings Programs: If you have low income, programs like QMB and SLMB can help pay your premiums and out-of-pocket costs.
- Extra Help: Provides assistance with prescription drug plan costs.