MassHealth is Massachusetts's version of Medicaid, but with its own rules and programs

Yes, MassHealth is Medicaid. It is the name Massachusetts uses for its Medicaid program — the joint federal and state health insurance program for people with low income. When you hear "Medicaid" in Massachusetts, the state calls it MassHealth. When you apply for Medicaid in Massachusetts, you are applying for MassHealth. The two terms refer to the same coverage.

However, MassHealth has its own may be able to access rules, benefit packages, and program names that differ from Medicaid in other states. This matters because income limits, covered services, and how you enroll work differently in Massachusetts than they do in New York, Connecticut, or any other state. If you have lived in Massachusetts for a while or are new to the state, understanding which MassHealth program fits your situation is more useful than knowing the federal name.

Key Takeaways

  • MassHealth is Massachusetts's Medicaid program — the state's name for the same federal-state health insurance for people with low income.
  • Massachusetts has multiple MassHealth programs with different income limits and rules: MassHealth Standard, Essential, Family Assistance, and others.
  • Income limits and covered services in MassHealth differ from Medicaid in other states because each state sets its own rules within federal guidelines.
  • You enroll in MassHealth through the state's Health Connector or directly through MassHealth, not through a federal office.
  • MassHealth covers doctor visits, hospital care, prescription drugs, and mental health services, though coverage details vary by which program you are in.

How MassHealth fits into the Medicaid system

Medicaid is a federal program, but each state runs its own version and sets its own rules. Massachusetts chose to call its program MassHealth. Other states use different names — California calls it Medi-Cal, New York calls it Medicaid, Texas calls it CHIP or Medicaid — but they are all the same federal program with state-level differences.

The federal government sets a floor: states must cover certain groups of people and certain services. But states can cover more people, offer more services, and set their own income limits. Massachusetts has chosen to cover more people than the federal minimum requires, which is why MassHealth has higher income limits than Medicaid in many other states.

When you move to Massachusetts or apply for coverage here, you are entering the MassHealth system, not a separate program. Your coverage is Medicaid. The name change is just how Massachusetts refers to it.

The different MassHealth programs and their income limits

Massachusetts runs several MassHealth programs, each with its own income limit and rules. MassHealth Standard covers adults, children, and families with the lowest income. MassHealth Essential covers people slightly above the Standard limit. MassHealth Family Assistance covers families with children. MassHealth Limited covers people who do not meet income limits but need specific services like pregnancy care or dialysis.

Income limits change each year and depend on family size. For example, in 2024, a single adult might may have access to for MassHealth Standard at one income level, but a family of four would have a different limit. The state publishes these limits on its website, and the Health Connector can tell you which program you may be in based on your household income.

Because income limits vary by program and change annually, there is no single number to remember. Instead, when you contact MassHealth or the Health Connector, have your recent pay stubs or tax return ready so they can tell you which program fits your situation.

What MassHealth covers compared to other states' Medicaid

All Medicaid programs must cover certain basics: doctor visits, hospital stays, emergency care, and prescription drugs. MassHealth covers these, plus mental health services, substance use treatment, and dental care for adults — benefits that not all states' Medicaid programs include.

However, the details matter. MassHealth's copays, which doctors are in-network, and how long you can stay in the hospital may differ from Medicaid in another state. If you are moving to or from Massachusetts, or comparing coverage across states, ask MassHealth directly what is covered under your specific program rather than assuming it matches what you had elsewhere.

How to enroll in MassHealth

You do not apply for Medicaid through a federal office. In Massachusetts, you enroll in MassHealth through the Health Connector, the state's insurance marketplace, or directly through MassHealth. You can apply online at the Health Connector website, by mail, by phone, or in person at a MassHealth office.

The Health Connector is often the fastest route because it handles both MassHealth and private insurance plans in one place. If you call the Health Connector, they can tell you which MassHealth program you may be in and walk you through the application. MassHealth also has its own phone line and local offices if you prefer to work directly with the state.

You will need proof of income (pay stubs, tax return, or a letter from your employer), proof of citizenship or immigration status, and proof of residency in Massachusetts. The exact documents depend on your situation, so ask when you contact them.

MassHealth and other health insurance programs

MassHealth is separate from Medicare, which is federal health insurance for people 65 and older or with certain disabilities. If you are may be able to access for both MassHealth and Medicare, you are considered "dual may be able to access," and both programs work together to cover your care. MassHealth covers costs that Medicare does not, like long-term care and dental work.

MassHealth is also separate from private insurance you might buy through your job or the Health Connector. If you have a job that offers health insurance, you may not be able to enroll in MassHealth, depending on your income and the cost of the job-based plan. MassHealth looks at whether the job insurance is "affordable" before deciding whether you can use MassHealth instead.

Why the name matters less than the program you are in

Knowing that MassHealth is Medicaid helps you understand that you are part of a federal program with state rules. But what actually matters for your care is which MassHealth program you are in — Standard, Essential, Family Assistance, or Limited — because that determines your income limit, your copays, and what services are covered.

When you contact MassHealth or the Health Connector, focus on your household income, family size, and what services you need. They will tell you which program fits and what to do next. The federal name is just context; the state program is what affects your coverage.

Frequently Asked Questions

Is MassHealth the same as regular Medicaid?

Yes, MassHealth is Medicaid — it is just what Massachusetts calls its Medicaid program. Every state runs Medicaid under a different name and with different rules. In Massachusetts, that program is MassHealth.

Can I use my MassHealth coverage if I move to another state?

No. MassHealth coverage ends when you move out of Massachusetts. You will need to enroll in that state's Medicaid program. Contact the new state's Medicaid office or health insurance marketplace to find out what programs are available and how to apply.

What is the income limit for MassHealth?

Income limits vary by program and family size and change each year. MassHealth Standard has the lowest limit, and other programs cover people with higher income. Contact the Health Connector or MassHealth directly with your household income and family size to find out which program you may be in.

Do I have to pay premiums for MassHealth?

Most MassHealth programs have no premium, but some have small copays when you use services. MassHealth Limited and some other programs may have monthly premiums depending on your income. Ask when you apply which program you are in and what costs apply.

How long does it take to get MassHealth coverage?

MassHealth typically processes applications within 30 days, though emergency coverage may start sooner. If you are pregnant, homeless, or in another urgent situation, tell MassHealth when you apply — they may start coverage faster while they review your full application.