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

People under 65 use the ACA-3, most often online; people 65 or older, and anyone who needs long-term care, file a separate form called the SACA-2. Getting that split right matters: sending a senior to the under-65 online application, or filing a SACA-2 for a working-age adult, is the most common way people lose weeks. This guide walks through each route, how to submit, what to gather, how long a decision takes, and what to do if you are denied. If you are not sure you qualify yet, start with MassHealth eligibility and income limits.

Before You Apply: Which MassHealth Application Is Yours

Massachusetts decides MassHealth two different ways, and the application follows the same split.

  • Under 65 (children, families, adults), 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. An MA Login account is the fastest route. This is the income-based application most working-age households use.
  • 65 or older, or any age needing long-term care: apply with the SACA-2, the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services. This is the route for nursing-home coverage, home-based long-term care, and regular MassHealth for people 65 and older.

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 by age and long-term-care need

People under 65 (children, families, and working-age adults) who are not living in or about to enter a nursing facility use the ACA-3, the Massachusetts Application for Health and Dental Coverage and Help Paying Costs. People 65 or older who do not fall into those categories, and anyone of any age who needs long-term-care services, use the SACA-2, the Application for Health Coverage for Seniors and People Needing Long-Term-Care Services.

2
Step 2

Gather your documents before you start

Most applicants need proof of identity and a Social Security number for everyone applying, proof of income (benefit award letters, pension statements, pay stubs), and proof of Massachusetts residency and immigration or citizenship status. Seniors and long-term-care applicants also need asset records, because MassHealth asks SACA-2 applicants for proof of income and assets. 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. Submitting complete documentation up front is the best way to avoid the back-and-forth that delays a decision.

3
Step 3

Submit the application

If you are under 65, file the ACA-3 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. Answering fast is the single biggest thing you control, especially 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. Assets above that level generally must be spent down on the cost of care before coverage begins.

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, 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 on the agency, not promises of a decision by that date. Nursing-facility applications, which carry an asset review and a separate medical-eligibility determination, routinely take longer than a standard MAGI application. The single best way to keep your case moving is to respond quickly when MassHealth requests more information, and to submit 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.

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. MassHealth's own deadline is shorter and is fully enforceable against 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)). Because that is a receipt deadline rather than a postmark one, do not mail on day 60. Check the notice the day it arrives and request the hearing in writing, by the date it gives, using the instructions on it.

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 Phone line for seniors and long-term-care applicants, and for questions about any application. 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. 1-800-841-2900
MassHealth ACA-3 Application (under 65) For children, families, and working-age adults not entering a nursing facility. 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?

For seniors and long-term care, call MassHealth Customer Service at 1-800-841-2900 (TDD/TTY 711). People under 65 generally file the ACA-3 online through an MA Login account.

How does a senior apply for MassHealth?

People 65 or older use the SACA-2 application (Application for Health Coverage for Seniors and People Needing Long-Term-Care Services), not the under-65 online application. 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 60-month (five-year) look-back, 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. People under 65 file the ACA-3 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. Those are limits on MassHealth, not a guaranteed decision date: long-term-care cases with a full asset review and a clinical assessment often run the full window or longer.

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 ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidMassachusetts Medicaid (MassHealth): the full guideMassachusetts Medicaid (MassHealth) explained: 1634 + medically-needy state, $2,000 asset limit, $72.80 PNA, 50% spousal share, 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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