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 turns on three things: your monthly income, your countable assets, and the program you are applying for. This guide gives the 2026 limits for each program older adults and people with disabilities most often use, and 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. Almost every senior reading this guide takes it.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: a tool that shows one income number and never mentions an asset limit is running the wrong test for an older adult.1

Massachusetts uses Supplemental Security Income (SSI) methodology and grants automatic eligibility to SSI recipients. Because the state contracts with the Social Security Administration to decide Medicaid eligibility for them, an SSI payment establishes MassHealth Standard with no separate application; 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 routing excess income through a qualified income trust, the pivotal difference for families moving from income-cap states such as Texas or Florida.2

If You Are Under 65 and Not Yet on Medicare

A working-age adult, including someone 60 to 64 not yet on Medicare, takes a different and more generous rule than the non-MAGI test above.

Massachusetts is one of the 41 states (including the District of Columbia) that adopted the ACA Medicaid expansion.4 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, about $1,835 a month for one person in 2026, against a $15,960 poverty guideline.5,6 This MAGI pathway applies no asset test, so savings, a car, and a retirement account do not count against you.5 One caveat: MAGI counts your Social Security benefit in full, including any non-taxable portion that never reaches your tax return.7

That door closes when 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, a lower yardstick and a resource test that never applied before, 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

Behind those figures: the 2026 poverty guideline is $15,960 a year for one person and $21,640 for two, about $1,330 and $1,803 a month.6 MassHealth's own chart publishes the household-of-two standard as $1,804, so use the MassHealth figure against a MassHealth limit.1

When one spouse needs long-term care, federal spousal-impoverishment rules protect assets for the spouse who stays home, and Massachusetts protects more than the half-share formula families usually read about. Under 130 CMR 520.016(B)(2)(a) the community spouse's asset allowance is the couple's entire combined countable assets at the snapshot date, up to a maximum resource standard of $162,660 for 2026. No one-half computation appears anywhere in the Massachusetts rule, so a couple below the maximum protects all of their countable assets, not half. The $32,532 figure MassHealth also publishes is the federal minimum a state may elect, not the level Massachusetts applies. The community spouse also has a minimum monthly maintenance needs allowance of $2,705.00 effective July 1, 2026, and the institutionalized spouse keeps a $72.80 personal needs allowance. One open point: the codified 130 CMR 520.016(B)(2)(a)1 still carries an older $109,560 cap while MassHealth's current program financial guidelines publish $162,660. The full-share structure holds under either figure, but confirm which ceiling MassHealth applies before you plan against it.1

The MassHealth Programs for Seniors and People with Disabilities

MassHealth Standard

The full-coverage program: hospital and physician care, prescription drugs, long-term services and supports, and behavioral health. For community residents 65 or older, 130 CMR 519.005 sets the limits in the table above.1 SSI recipients qualify automatically, and an applicant over the income limit but within the asset limit can still qualify through the 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 qualify if they meet the disability criteria. Higher-income members pay a sliding-scale monthly premium and lower-income members pay nothing; confirm the current schedule with MassHealth, since operational memos adjust it.

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; 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 Full detail 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, at the $2,982-a-month income limit and $2,000 asset limit in the table above.1 An applicant must be 60 to 64 with a disability or 65 or older, need at least one waiver service a month, and live in a qualifying community setting: your own home, a family member's home, or Congregate Housing, and not an assisted living residence, group home, or rest home.10 Applications and clinical assessments run 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 under 130 CMR 519.007 for people who need nursing-facility-level care and live in a PACE service area, bundling all Medicare and MassHealth services through one provider organization. The financial test matches the Frail Elder Waiver above.1 The age test does not: PACE starts at 55.10

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 100% of poverty but your assets are within the limit, you are not disqualified.1 You reach eligibility through the medically-needy deductible, the regulations' term for what 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 starting the first day of the month of application, or up to three months earlier, but you get that retroactive stretch only if you incurred medical expenses MassHealth covers during it and were otherwise eligible then.2
• The 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
• A bill counts only if it clears four criteria under 130 CMR 520.032(A): not subject to further payment by health insurance or other liable third-party coverage, including the Health Safety Net; for an allowable medical or remedial-care expense; unpaid and a current liability, or paid during the current six-month period; and not already applied to another deductible period. Any portion you do not use carries into a future period.2
• Once your incurred expenses reach the deductible, MassHealth Standard activates for the rest of the six-month period. The bills you used to meet it stay your own responsibility and cannot be submitted to MassHealth; only bills incurred afterward 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 amount if your countable income still exceeds the standard.2

The $522 single and $650 couple limit is a fixed dollar table set by 130 CMR 520.030, published as its own column on the 2026 income-standards schedule rather than as a poverty-level percentage.2 For the full calculation and how to time medical bills, see the MassHealth medically-needy spend-down guide.

The deductible is the community route to Standard, not the long-term-care patient-paid amount, which sets how much of an institutionalized resident's income goes to the facility after a $72.80 personal needs allowance and other deductions.11,2

Asset Rules: What Counts and What Does Not

Against the $2,000 single / $3,000 couple limit set by 130 CMR 520.003, what matters is which of your assets MassHealth counts.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 the home equity ceiling 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; 130 CMR 520.007 governs how an IRA or a former-employer pension is counted. Confirm your own account's treatment 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. MassHealth publishes a maximum home equity limit of $1,130,000 for 2026, which is also the federal maximum a state may elect; the federal minimum is $752,000.1,12

Three things soften that ceiling, and families over the limit routinely miss them. First, the equity test does not apply at all while your spouse, your child under 21, or your blind or permanently and totally disabled child is lawfully residing in the home, so equity of any amount does not by itself disqualify. Second, federal law says nothing in the equity rule prevents you from using a reverse mortgage or a home equity loan to bring equity below the limit.12 Third, 130 CMR 520.007(G) lets MassHealth waive the period of ineligibility caused by excess equity in real estate if you meet the conditions at 130 CMR 520.007(G)(13).1

Under the 2025 federal budget reconciliation law (H.R. 1, Public Law 119-21, section 71108), a flat $1,000,000 ceiling with no inflation indexing takes effect January 1, 2028 for homes not on agriculturally zoned land, bringing the Massachusetts figure down for those homes; a home on a lot zoned for agricultural use stays under the existing indexed-limit rules. The amendment reaches only the dollar limit, so the spouse-and-child disapplication, the reverse-mortgage route, and the federal hardship waiver all survive it.12

The Medicare Savings Programs

These are the most underappreciated piece of MassHealth for moderate-income seniors. 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 and many seniors who would not qualify anywhere else qualify here. 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

QMB pays the Medicare Part B premium, $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 For the full walkthrough, see the MassHealth Medicare Savings Programs guide.

2025 and 2026 Changes That Affect Eligibility

Mandatory Medicare enrollment at age 65 (EOM 25-10). Under MassHealth Eligibility Operations Memo 25-10, issued in June 2025, members 65 or older who receive MassHealth Standard and have income at or below 190% of poverty must enroll in Medicare as a condition of MassHealth eligibility. Outside the rule: people 65 or older with income above 190% of poverty, people younger than 65, and people not eligible for MassHealth Standard, CommonHealth, or Family Assistance. Members who are not eligible for Medicare will not lose MassHealth.14

The 60-day clock is easy to misread as a countdown to losing coverage. It reaches MassHealth members who are Qualified Medicare Beneficiaries: a letter from the Medicare Enrollment Support Project team tells them to make an appointment to apply for Medicare within 60 days of receiving it. That is a deadline to book the Social Security appointment, not a grace period before MassHealth ends. A member eligible for Medicare who never applies, after all outreach attempts, does lose coverage; the route back needs no new application: call the Medicare Enrollment Support Project at (877) 935-1280 and schedule a Social Security appointment within 90 days.14

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 to stay in a SCO plan; MassHealth attributes the change to M.G.L. c. 118E, § 9D. Members without both Medicare parts moved to MassHealth Fee-For-Service that day and kept their Standard coverage. The move is not one-way: a member who later obtains Parts A and B can call (800) 841-2900, or the SCO plans directly, about getting back in. One gap meanwhile: Fee-For-Service members get no care coordinator or case manager, and MassHealth points a member who needs one to the Frail Elder Waiver through their local Aging Services Access Point.15

The companion One Care program is not a seniors' program: the Executive Office of Health and Human Services describes it as serving dual eligible adults with disabilities ages 21 through 64 at enrollment, though turning 65 while enrolled does not end it. Massachusetts is moving One Care off the federal Medicare-Medicaid Plan demonstration, which sunsets at the end of 2025, and onto a Dual Eligible Special Needs Plan (D-SNP) platform effective January 1, 2026. Treat that as a stated effective date, not a completed switch: EOHHS says plans may begin coverage on or after that date subject to remaining conditions, so confirm your own plan's status. Each plan must be a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) with exclusively aligned enrollment: one plan for both Medicare and MassHealth.16 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; confirm the current rule with MassHealth before planning against it.

How to Apply

Age 65 is not by itself the dividing line between the senior form and the working-age form.

If you need long-term-care services at any age (in a medical institution such as a nursing facility or chronic hospital, or through certain home-delivered long-term-care programs), 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. People 65 or older living at home use SACA-2 as well, unless one of three carve-outs describes them.12

Those carve-outs send you to the under-65 form. Mass.gov says you may use the Massachusetts Application for Health and Dental Coverage and Help Paying Costs (form ACA-3, 03/26 edition) "regardless of your age, even if you are over age 65" if you are the parent of a child younger than 19, the adult relative of a child who is living with and taking care of that child because neither parent is in the home, or not working. One ambiguity is worth a phone call: "not working" appears on both forms' lists, so a person 65 or older who is not working is described by each, and mass.gov does not say which to file. Ask MassHealth at 1-800-841-2900.12 Everyone under 65 who is not living in or about to enter a nursing facility uses ACA-3.

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, because it includes a review of asset transfers reaching back 60 months 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.