To apply for MassHealth (Massachusetts Medicaid), you use one of two applications, and which one depends on your age, your household, and whether you need long-term care.

People under 65 who are not living in or about to enter a nursing facility use the ACA-3, which can be filed online; anyone who needs long-term care, at any age, files a separate form called the SACA-2, and so do people 65 or older who fall outside the ACA-3's exceptions. Age 65 is not a hard line: a parent of a child under 19, or an adult relative raising a child whose parents are not in the home, can use the ACA-3 at any age. If you are not sure you qualify yet, start with MassHealth eligibility and income limits.

Before You Apply: Which MassHealth Application Is Yours

Massachusetts uses two different MassHealth applications, and which one you file turns on your age, your household, and whether you need long-term care.

  • Under 65, and not living in or about to enter a nursing facility: apply with the ACA-3, the Massachusetts Application for Health and Dental Coverage and Help Paying Costs. You can file it online through an MA Login account, or by mail, fax, phone, or in person.
  • Any age, if you need long-term care: apply with the SACA-2, the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services. That covers care in a medical institution such as a nursing facility or chronic hospital, and certain programs that provide long-term-care services so you can live at home.
  • 65 or older and living at home: the SACA-2 is your form unless an ACA-3 exception fits. Mass.gov lets you use the ACA-3 at any age if you are the parent of a child under 19, or an adult relative living with and caring for a child whose parents are not in the home.
  • A married couple applying together, one spouse 65 or older and one younger, with no children under 19 at home: the younger spouse may go on the SACA-2 with the older one rather than on the ACA-3.

One case mass.gov leaves open: "not working" appears on both applications' lists of who may use them, and neither page says which one a person 65 or older who is not working should file. If that is you, ask MassHealth before you start.

Steps to Apply for MassHealth

Once you know which application is yours, the path to a decision is the same short sequence. Get the form right, gather your proof, submit, and respond promptly to any request for more information.

1
Step 1

Pick your application

Use the ACA-3 if you are under 65 and not living in or about to enter a nursing facility, or if you are any age and the parent of a child under 19 or an adult relative raising a child whose parents are not in the home. Use the SACA-2 if you need long-term-care services, at any age, or if you are 65 or older and none of the ACA-3's exceptions fit you.

2
Step 2

Gather your documents before you start

MassHealth asks SACA-2 applicants for proof of income and assets, so have income records (benefit award letters, pension statements, pay stubs) and asset records ready. If the applicant is a nursing-facility resident, transfers of resources are also subject to a look-back period that, for transfers made on or after February 8, 2006, generally extends back 60 months (five years), so gather bank and investment statements, property records, and documentation of any transfers in that window. MassHealth must also verify a declared U.S. citizenship or satisfactory immigration status, though people enrolled in any part of Medicare or receiving SSI do not have to provide documents to prove citizenship. Submitting complete documentation up front helps you avoid the back-and-forth that can delay a decision.

3
Step 3

Submit the application

If you are filing the ACA-3, you can file it online through an MA Login account, by mail to the Health Insurance Processing Center, PO Box 4405, Taunton, MA 02780, by fax to (857) 323-8300, by phone to the MassHealth Customer Service Center, or in person with an enrollment assister or at a MassHealth Enrollment Center. If you are filing the SACA-2, you can complete and submit it online, or print it, complete it by hand, and mail or fax it with your documents to the MassHealth Enrollment Center. Note that the two applications go to different addresses.

4
Step 4

Respond quickly to any request for more information

MassHealth may ask for missing documents before it can decide. How fast you answer is in your hands, and it matters most for nursing-facility cases, which carry an asset review and a separate finding that you are medically eligible for nursing-facility services.

If you are applying for a parent who is entering a nursing home, the SACA-2 is your form no matter the parent's age, and it covers both the financial side and the paperwork the asset review needs.

If Your Income Is Over the Limit: Massachusetts Is a Spend-Down State

Massachusetts is a medically-needy state, not an income-cap state. A senior whose countable income is above the MassHealth income standard is not automatically turned away and does not need to set up a qualified income trust (a Miller trust). Instead, they can qualify by meeting a deductible, called a spend-down, measured over a six-month period.

MassHealth does still apply an asset limit for seniors and long-term-care applicants: $2,000 for an individual and $3,000 for a couple living together in the community. Only countable assets count toward that limit. Your home in Massachusetts, for example, is noncountable while you use it as your principal residence, unless its equity exceeds the home-equity limit.

If your income is over the standard, do not skip applying. Work through the MassHealth medically-needy spend-down and the figures on MassHealth eligibility and income limits before you decide you are ineligible.

How Long a MassHealth Decision Takes

Federal law caps how long the state may take. Under 42 CFR 435.912, except in unusual circumstances, a MassHealth determination may not exceed 45 days for most applicants, or 90 days for people who apply for Medicaid on the basis of disability. The longer window turns on the basis the application was filed under, not on whether a disability determination happens to arise in the case: a senior who applies for long-term-care coverage on the basis of age is on the 45-day standard, even if medical records are part of the file.

Those are ceilings, and the regulation gives examples of the unusual circumstances that can excuse a longer wait: the applicant or an examining physician delaying or failing to take a required action, or an emergency beyond the agency's control. If MassHealth does run late, it must document the reasons in your case record, and it may not use the time standards as a waiting period or as a reason to deny you. A delay on your side is one of the listed excuses, so you keep your case moving by responding quickly when MassHealth requests more information and by submitting a complete document package up front.

Why Your Application Date Matters: Retroactive Coverage

The date you apply sets your coverage window. Under federal law (42 CFR 435.915), once MassHealth approves you, coverage can reach back to cover services you received in or after the third month before the month you applied, if you would have been eligible then. That back-coverage can pay bills already incurred, which is why applying sooner rather than later protects you. Three months is the federal default, though, and an approved Section 1115 demonstration can give a state a shorter window, so ask MassHealth which window applies to your case.

This window is shrinking. For applications filed on or after January 1, 2027, federal law (Public Law 119-21) shortens retroactive coverage to two months before the application month for most enrollees, and one month for adults covered through the Medicaid expansion group for low-income adults.

If MassHealth Denies Your Application: Appeals

A denial or a reduction in coverage can be appealed through a fair hearing. Under 42 CFR 431.221(d), the state must allow a reasonable time, not to exceed 90 days from the date the notice of action is mailed, to request that hearing. Read that 90 days as a ceiling on the state, not as a window you are guaranteed. For an appeal of a MassHealth decision, such as a denial of your application, MassHealth's own deadline is shorter, and it is the one that binds you: the Board of Hearings must receive your request within 60 calendar days after you receive written notice of the agency's intended action (130 CMR 610.015(B)(1)), and the notice is presumed received on the fifth day after it was mailed unless there is evidence otherwise. Other actions carry other windows. Some nursing-facility discharge and transfer notices allow only 30 or 14 days, and if MassHealth never acts on your application at all, you have 120 days from the date you applied, unless the Board of Hearings Director or a designee waives that limit.

Because these deadlines run on when the Board of Hearings receives your request, not on a postmark, don't mail on the last day. Check the notice the day it arrives. You can send the MassHealth Fair Hearing Request Form, with a copy of the notice, by fax to the Board of Hearings at 1-617-887-8797 or by email to boh-fairhearingsrequest@mass.gov (MassHealth accepts only password-protected attachments), or request a hearing by phone through MassHealth Customer Service at 1-800-841-2900.

For nursing-facility coverage, remember that the financial determination from your SACA-2 works alongside a clinical requirement: MassHealth (or its agent) must determine that you are medically eligible for nursing-facility services before it will pay for them. A denial can turn on either side, so read the notice carefully to see which one was not met.

Where to Get Help Applying

If you get stuck, these are the official contacts for the two MassHealth application routes.

MassHealth Customer Service File the ACA-3 by phone, or ask about either application. TDD/TTY 711. 1-800-841-2900 www.mass.gov/masshealth
MassHealth Enrollment Center Central Processing Unit, P.O. Box 290794, Charlestown, MA 02129-0214. Mail or fax (617-887-8799) the printed SACA-2 and your documents here.
MassHealth ACA-3 Application For people under 65 who are not living in or entering a nursing facility, and at any age for the parent of a child under 19 or an adult relative raising a child whose parents are not in the home. File online through an MA Login account, or mail to the Health Insurance Processing Center, PO Box 4405, Taunton, MA 02780, or fax to (857) 323-8300. 1-800-841-2900 www.mass.gov/masshealth

Frequently Asked Questions

What's the phone number to apply for MassHealth?

MassHealth Customer Service is 1-800-841-2900 (TDD/TTY 711), and you can file the ACA-3 application by phone through that line. The ACA-3 can also be filed online through an MA Login account, and the SACA-2 for seniors and long-term care can be submitted online or by mail or fax.

How does a senior apply for MassHealth?

People 65 or older generally use the SACA-2 application (Application for Health Coverage for Seniors and People Needing Long-Term-Care Services). The exception: a parent of a child under 19, or an adult relative raising a child whose parents are not in the home, can use the ACA-3 at any age. You can submit the SACA-2 online or mail or fax it to the MassHealth Enrollment Center.

How do I apply for MassHealth long-term care?

Use the SACA-2 application at any age if you need long-term-care services. It covers the financial side, and MassHealth asks for proof of income and assets. If you are a nursing-facility resident, transfers of resources made on or after February 8, 2006 are also subject to a look-back that generally reaches back 60 months (five years), and MassHealth must separately determine that you are medically eligible for nursing-facility services before it pays for them.

Can I apply for MassHealth online?

Yes. The ACA-3 can be filed online through an MA Login account. The SACA-2 for seniors and long-term care can also be completed and submitted online, or printed and mailed or faxed to the MassHealth Enrollment Center.

How long does a MassHealth decision take?

Federal law caps it at 45 days for most applicants and 90 days for people who apply on the basis of disability, and which cap applies depends on the basis you applied under rather than on whether a disability determination comes up. MassHealth can go past them only in unusual circumstances, such as when the applicant or an examining physician delays a required step, and it may not deny an application because it ran out of time.

What's the mailing address for the SACA-2?

MassHealth Enrollment Center, Central Processing Unit, P.O. Box 290794, Charlestown, MA 02129-0214.

Your next step Start your MassHealth application at mass.gov, or call MassHealth Customer Service at 1-800-841-2900 (TDD/TTY 711) for help.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyHow to apply for Medicaid: the ways you can apply, the documents to gather, how long a decision takes, and the application guide for your state. MedicaidMassachusetts Medicaid (MassHealth): the full guideMassachusetts MassHealth explained: 1634 + medically-needy state, $2,000 asset limit, $72.80 PNA, 100% spousal share to $162,660, Chapter 197 estate recovery. MedicaidMassHealth Eligibility and Income Limits2026 MassHealth eligibility for seniors and people with disabilities: income limits, asset limits, the medically-needy spend-down, and savings programs. MedicaidThe MassHealth Medically-Needy Spend-DownMassachusetts Medicaid medically-needy spend-down 2026: the $522/$650 MNIL, six-month deductible mechanics under 130 CMR 520.028-520.035, and which bills count. MedicaidMassHealth Long-Term Care and Nursing-Home CoverageDoes MassHealth pay for a nursing home? A 2026 guide to Massachusetts Medicaid nursing home coverage, eligibility, patient-paid amount, and estate recovery. MedicaidHow to Qualify for Medicaid Without Going BrokeSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help applying for MassHealth 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.

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