MassHealth Eligibility & Income Limits 2026

In Massachusetts, being over the MassHealth income limit does not bar you from coverage the way it does in many states. Because Massachusetts is a medically-needy state rather than an income-cap state, a senior or person with a disability whose income is too high can still qualify by spending down through medical bills, instead of being forced into an income trust.

Eligibility in 2026 comes down to three things: your monthly income, your countable assets, and the program you are applying for. This guide gives the 2026 income and asset limits for each MassHealth program that older adults and people with disabilities most often qualify for, explains which financial test applies to you, and walks through the over-the-limit path.

In This Guide

• Which MassHealth Eligibility Test Applies to You in 2026
• If You Are Under 65 and Not Yet on Medicare
• The 2026 MassHealth Eligibility Income and Asset Limits by Program
• The MassHealth Programs for Seniors and People with Disabilities
• What Happens If You Are Over the Income Limit
• Asset Rules: What Counts and What Does Not
• The Medicare Savings Programs
• 2025 and 2026 Changes That Affect Eligibility
• How to Apply
• Frequently Asked Questions
• Learn More

Which MassHealth Eligibility Test Applies to You in 2026

MassHealth is the Massachusetts name for the state's Medicaid program. Before any dollar figure means anything, you have to know which of two financial tests applies to you, because seniors are routinely shown the wrong one.

Non-MAGI (SSI-related) rules apply to people 65 or older, people of any age who have Medicare, and anyone applying for long-term care, the Frail Elder Waiver, or PACE. This test counts both income and assets, with the $2,000 single / $3,000 couple asset limit set by 130 CMR 520.003, and it is the test almost every senior reading this guide will take.1

MAGI (Modified Adjusted Gross Income) rules apply to working-age adults, parents and caretaker relatives, pregnant women, and children. The MAGI test is income-only with no asset test. The trap is that online calculators surface a MAGI poverty-level percentage on senior searches when a senior's actual test is the non-MAGI pathway with its hard asset limit.1 If a tool shows you a single income number and never mentions an asset limit, it is almost certainly running the wrong test for an older adult.

Two structural facts shape the non-MAGI test in Massachusetts.

Massachusetts uses Supplemental Security Income (SSI) methodology and grants automatic eligibility to SSI recipients. Because Massachusetts contracts with the Social Security Administration to decide Medicaid eligibility for SSI recipients, an SSI payment establishes MassHealth Standard with no separate application, and the same federal SSI rules govern income disregards and countable resources for other non-MAGI applicants.

Massachusetts is a medically-needy state, not an income-cap state. Under the federal medically-needy option at 42 CFR 435.831, an applicant whose income is too high can still qualify by deducting medical expenses, rather than being forced to route excess income through a qualified income trust.2 This is the single most consequential distinction for families moving from income-cap states such as Texas or Florida: in Massachusetts, income above the limit triggers a spend-down, not a Miller trust.

If You Are Under 65 and Not Yet on Medicare

A working-age adult, including someone 60 to 64 who is not yet on Medicare, takes a different and more generous rule than the non-MAGI test above, and it is the one online searches most often surface.

Massachusetts is one of the 41 states (including the District of Columbia) that adopted the ACA Medicaid expansion.4 Under it, adults 19 to 64 who are not pregnant and not enrolled in Medicare qualify for MassHealth Standard with income up to 138% of the federal poverty level: roughly $1,835 a month, about $22,000 a year, for one person in 2026, against a $15,960 poverty guideline.5,6 This MAGI pathway applies no asset test at all, so savings, a car, and a retirement account do not count against you here.5 One caveat applies: MAGI counts your Social Security benefit in full, including any non-taxable portion that never reaches your tax return, so an early-retirement or disability check is not invisible income.7

This particular door, the expansion adult group, closes the day you turn 65 or become entitled to Medicare, because the group is written by statute for people under 65 who are not enrolled in Medicare.5 Turning 65 does not by itself end MAGI eligibility, though. Federal law sets the MAGI methods aside for people 65 or older only when age is a condition of eligibility for the group being tested, so someone 65 or older who qualifies as a parent or other caretaker relative is still measured by MAGI and still faces no asset test.8 If no such group fits you, you shift to the aged, blind, and disabled track above, measured against the SSI federal benefit rate of $994 a month for one person in 2026 and carrying the $2,000 asset test. That is a lower income yardstick and a resource test that never applied before, even though nothing about your income has changed.9

The 2026 MassHealth Eligibility Income and Asset Limits by Program

All figures below are 2026. Poverty-level standards take effect at MassHealth on March 1, 2026, so applications filed in January or February 2026 use the prior year's figures.1

The federal anchors behind these figures for 2026: the poverty guideline is $15,960 a year for one person and $21,640 for two, which works out to about $1,330 and $1,803 a month.6 MassHealth publishes the household-of-two standard on its own chart as $1,804, so use the MassHealth figure when testing yourself against a MassHealth limit.1 The 300% special income level used for the Frail Elder Waiver and PACE is $2,982 per month.1 The asset limit of $2,000 single and $3,000 couple is fixed by 130 CMR 520.003.1

For married couples where one spouse needs long-term care, federal spousal-impoverishment rules protect a portion of the couple's assets for the spouse who stays at home. In 2026 the community spouse keeps the greater of half the couple's countable assets up to $162,660 or a floor of $32,532, and a monthly maintenance needs allowance of at least $2,705.00 (effective July 1, 2026). The institutionalized spouse keeps a $72.80 personal needs allowance.1

The MassHealth Programs for Seniors and People with Disabilities

Each MassHealth program carries its own income standard and scope of coverage.

MassHealth Standard

The full-coverage program. It covers hospital and physician care, prescription drugs, long-term services and supports, behavioral health, and more. For community residents 65 or older, eligibility under 130 CMR 519.005 requires income at or below 100% of poverty ($1,330 per month for a household of one, $1,804 for a household of two on the MassHealth chart) and assets at or below $2,000 single / $3,000 couple.1 SSI recipients qualify automatically. An applicant over the income limit but within the asset limit can still qualify through the medically-needy spend-down.2

MassHealth CommonHealth

The program for working and non-working people with disabilities, with no income ceiling and no asset test under 130 CMR 519.012. Adults 65 or older can qualify if they meet the disability criteria. CommonHealth charges a monthly premium for higher-income members on a sliding scale, while lower-income members pay nothing; confirm the current premium schedule with MassHealth, since the thresholds are set by operational memo and adjusted periodically.

Senior Buy-In and Buy-In (the Medicare Savings Programs)

Senior Buy-In was the Massachusetts brand name for the federal Qualified Medicare Beneficiary (QMB) program; it pays Medicare Part A and Part B premiums and covers Medicare deductibles and coinsurance. Buy-In covers the Part B premium and corresponds to the federal SLMB and QI programs. MassHealth now calls both simply the Medicare Savings Programs, though the regulation still carries "(Buy-in)" in its section titles, so you will meet both names.3 These are the Medicare Savings Programs, and none of them has an asset test in Massachusetts; the income limits run higher than the federal floor.3 These programs are detailed in the Medicare Savings Programs section below.

Frail Elder Waiver

A home- and community-based services waiver under 130 CMR 519.007 for people who would otherwise need nursing-facility-level care but can be supported at home. The 2026 income limit is $2,982 per month for one person (300% of the SSI federal benefit rate) and the asset limit is $2,000.1 Age matters here: an applicant must be either 60 to 64 with a disability or 65 or older. You also have to need at least one waiver service a month and live in a qualifying community setting, which means your own home, a family member's home, or Congregate Housing, and not an assisted living residence, group home, or rest home.10 Functional eligibility is assessed through the Aging Services Access Point network. Services include personal care, homemaker services, adult day health, respite, and home modifications.

PACE (Program of All-Inclusive Care for the Elderly)

A fully integrated managed-care program for people 55 or older who need nursing-facility-level care but live within a PACE service area, under 130 CMR 519.007. The financial test matches the Frail Elder Waiver: $2,982 a month for one person, $2,000 in assets.1 PACE bundles all Medicare and MassHealth services through a single provider organization. Note the age difference: PACE serves people 55 and older, while the Frail Elder Waiver takes applicants who are 60 to 64 with a disability or 65 or older.10

MassHealth Family Assistance and MassHealth Limited

Family Assistance mostly serves children and younger families; the pathway that reaches adults, under 130 CMR 519.013, covers HIV-positive individuals with documented status. MassHealth Limited is emergency-only coverage under 130 CMR 519.009 for certain noncitizens who otherwise meet Standard criteria.

What Happens If You Are Over the Income Limit

If your income is above the 100%-of-poverty limit for MassHealth Standard but your assets are within the limit, you are not disqualified.1 You can establish eligibility through the medically-needy deductible, which Massachusetts regulations call the deductible and most families call a spend-down.2

The mechanism, set by 130 CMR 520.028 through 520.035:

• The deductible runs over a six-month period that starts on the first day of the month of application and can reach up to three months earlier.2
• The deductible amount equals your excess monthly income (the amount over the medically-needy income limit of $522 for one person or $650 for a couple in the community) multiplied by six.2
• As you incur medical bills during the period, they count toward the deductible. A bill counts if it is unpaid and currently owed, or if it was paid during the current period, and it must not be covered by other insurance. The bills must be owed; they do not have to be paid.2
• Once your incurred medical expenses reach the deductible amount, MassHealth Standard activates for the rest of the six-month period. The bills you used to meet the deductible stay your own responsibility and cannot be submitted to MassHealth for payment; only new bills incurred after the deductible is met are covered.2
• The period does not renew on its own. At the end of it, MassHealth notifies you in writing of a new deductible period and a new amount if your countable income still exceeds the applicable standard.2

The $522 single and $650 couple medically-needy limit is a fixed regulatory standard, not pegged to the poverty level.2 For a deeper walkthrough of the spend-down calculation and how to time medical bills, see the MassHealth medically-needy spend-down guide.

The deductible is not the same as the long-term-care patient-paid amount. The patient-paid amount governs how much of an institutionalized resident's income goes to the nursing facility after a $72.80 personal needs allowance and other deductions.11 The deductible is how a community applicant over 100% of poverty reaches Standard eligibility.2

Asset Rules: What Counts and What Does Not

The non-MAGI asset limit is $2,000 for one person and $3,000 for a couple in the community, under 130 CMR 520.003.1

Countable assets include cash and bank accounts, certificates of deposit, stocks, bonds, and mutual funds, the full balance of IRAs and most retirement accounts, real estate other than the principal residence, and equity in additional vehicles.

Non-countable assets include the principal residence (subject to a home equity ceiling, discussed below), one household vehicle of any value, a burial fund of limited value, irrevocable burial contracts, and certain special-needs and pooled trusts.

The retirement-account trap. Massachusetts does not exempt an IRA or 401(k) simply because it is in payout status the way some states do. How an IRA or a former-employer pension is counted is set by 130 CMR 520.007, and families and advisors who carry in an out-of-state assumption that "the IRA is exempt once it is in payout status" can make costly mistakes. Confirm the treatment of your own account with MassHealth or an elder-law attorney before you restructure it; the tool most often used in Massachusetts is a Medicaid-compliant annuity.

Home equity ceiling. Massachusetts adopts the upper-tier federal home equity exclusion, which is $1,130,000 for 2026.12 Under the federal budget reconciliation law enacted in 2025 (H.R. 1, Public Law 119-21, section 71108), a flat $1,000,000 ceiling with no inflation indexing takes effect on January 1, 2028 for homes that are not on agriculturally zoned land, so Massachusetts will lose its higher exclusion for those homes. A home on a lot zoned for agricultural use stays under the existing indexed-limit rules.12 Couples with non-agricultural home equity between those two figures have a planning window before that change.

The Medicare Savings Programs

These are the most underappreciated piece of MassHealth for moderate-income seniors, because Massachusetts raised the income limits well above the federal floor and, effective March 1, 2024, removed the asset test from every tier, so eligibility turns on income alone. The limits are 190% of poverty for QMB, 190% to 210% for SLMB, and 210% to 225% for QI: in 2026 dollars, roughly $2,527 per month for one person at the QMB level and up to $2,993 at the QI level.3

The practical effect is large. QMB pays the Medicare Part B premium, which is $202.90 per month in 2026, along with the Part A premium for those who did not earn 40 work quarters, plus Medicare deductibles and coinsurance.13 Because the Massachusetts limit runs to 190% of poverty rather than the federal 100%, and because the asset test is gone, many seniors who would not qualify anywhere else qualify here, and a modest nest egg does not disqualify them.3 For the full Massachusetts walkthrough, see the MassHealth Medicare Savings Programs guide.

2025 and 2026 Changes That Affect Eligibility

Several recent changes affect who can keep or reach coverage.

Mandatory Medicare enrollment at age 65 (EOM 25-10). Under MassHealth Eligibility Operations Memo 25-10, MassHealth Standard members 65 or older with income at or below 190% of poverty must enroll in Medicare as a condition of continued MassHealth eligibility. Members who are not eligible for Medicare do not lose MassHealth, and MassHealth provides a 60-day enrollment notice.14 If you get one of those notices, act on it inside the 60 days: this is a condition of keeping MassHealth, not a suggestion.

Senior Care Options now requires full dual eligibility. As of January 1, 2026, all Senior Care Options enrollees must have both Medicare Parts A and B and MassHealth Standard. Members who lacked both Medicare parts were moved to MassHealth Fee-for-Service on January 1, 2026, while keeping their MassHealth Standard coverage.15 The companion One Care plans for younger dual eligibles moved on the same date from the federal Medicare-Medicaid Plan demonstration, which sunset at the end of 2025, onto a Dual Eligible Special Needs Plan (D-SNP) platform, and the MassHealth One Care contract requires each plan to operate as a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) with exclusively aligned enrollment.16 For details on these integrated plans, see the MassHealth SCO and One Care guide.

Premium and PACE rule changes. MassHealth also moves rules between regulation updates through Eligibility Operations Memos, and 2025 and 2026 memos have touched CommonHealth and Family Assistance premiums and PACE eligibility. Brevy does not carry verified figures for those memos, and their specifics and effective dates are subject to revision, so confirm the current rule with MassHealth or your local Aging Services Access Point before relying on it for planning.

How to Apply

Seniors and people applying for long-term care use a different form than working-age adults. If you are 65 or older, or you need long-term-care services at any age, complete the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services (form SACA-2, 03/26 edition), which you can submit online through MassHealth or print and mail or fax to the MassHealth Enrollment Center in Charlestown. Everyone else under 65 who is not living in or about to enter a nursing facility uses the Massachusetts Application for Health and Dental Coverage and Help Paying Costs (form ACA-3) instead.12

MassHealth asks SACA-2 applicants for proof of income and assets, so gather your Social Security and Medicare cards, proof of residency, bank statements for every account, recent income documentation, life insurance policies, the deed to your home, vehicle registration, and any trust documents.12 A long-term-care application takes longer to decide than a community one, because it includes a review of asset transfers reaching back 60 months (five years) for transfers made on or after February 8, 2006.12

Learn More

Find personalized help understanding MassHealth eligibility and income limits at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.