If you are helping a Massachusetts parent or spouse qualify for long-term care, a handful of numbers shape most of the plan. Four matter most: a $2,000 asset limit, a $72.80 monthly personal needs allowance, a 50% spousal-share rule that lets the community spouse keep half the couple's assets (up to $162,660), and probate-only estate recovery with a $25,000 auto-waiver. Massachusetts Medicaid is branded MassHealth, administered by the Executive Office of Health and Human Services (EOHHS), and because it is a medically-needy state you do not need a Miller Trust to qualify over the income limit.,,

Massachusetts is both a 1634 state (SSI receipt confers MassHealth eligibility with no separate Medicaid application) and a medically-needy state, so applicants over the income limit qualify by spending down on real medical bills rather than by funneling income through a Miller Trust the way income-cap states require. That dual classification is the single most important framework fact for MassHealth planning, and it forecloses an entire class of planning errors families are told to make by out-of-state advisors.

In This Guide

The 60-Second Version

  • Massachusetts calls its Medicaid program "MassHealth." It is administered by the Executive Office of Health and Human Services (EOHHS).
  • 1634 state + medically-needy state. MA is a 1634 state: SSI receipt confers MassHealth eligibility with no separate Medicaid application. MA is also a medically-needy state, electing the optional spend-down route of 42 CFR 435.301 (130 CMR 519.005(B); 520.028 through 520.035), so applicants over the income standard qualify by meeting a deductible. No Miller Trust required, unlike income-cap states.
  • Asset limit: $2,000 for an individual and $3,000 for a couple living together in the community, under 130 CMR 520.003(A). Deductible-income standard (MNIL): $522/month for one person, $650/month for two, effective 3/1/2026. Maximum home equity limit: $1,130,000, the same figure as the 2026 federal maximum.
  • Personal Needs Allowance: $72.80/month under 130 CMR 520.026, deducted from the resident's income before the patient-paid amount is calculated. MassHealth's published long-term-care figures show the same $72.80 in 2023, 2024, 2025, and 2026. It sits well above the federal statutory floor of $30/month.
  • CSRA computation: MA is a 50% spousal-share state (130 CMR 520.016). The CSRA is the greater of 50% of combined countable assets at the snapshot date, capped at the federal maximum $162,660, or the federal minimum $32,532. With $200,000 combined assets, CSRA = $100,000, NOT $162,660.
  • MMMNA: $2,705.00/month standard (effective 7/1/2026) / $4,066.50 maximum in 2026. Massachusetts uses the federal income-first methodology required by the Deficit Reduction Act of 2005.
  • Estate Recovery: Chapter 197 of the Acts of 2024 narrowed recovery to the federally mandated minimum (nursing facility + HCBS + related hospital and prescription-drug services) for deaths on/after 8/1/2024. The pre-reform regime applies for deaths before 8/1/2024, recovering for all MassHealth services received at age 55 or older.
  • Estate Recovery is PROBATE-ONLY under M.G.L. c. 118E § 31. MassHealth cannot recover from assets outside the member's probate estate, so joint tenancy with survivorship, tenancy by the entirety, life-estate remainders, revocable and properly drafted irrevocable trusts, and beneficiary-designated accounts all pass outside recovery.
  • $25,000 auto-waiver (deaths on/after 5/14/2021): MassHealth waives recovery when the probate petition certifies under penalties of perjury that the estate's total assets are $25,000 or less. No formal waiver application required.
  • Hardship waivers under 130 CMR 515.011 must be requested within 60 days of MassHealth's notice of claim. Two categories: a residence-and-financial-hardship waiver (heir family-group income at or below 133% FPL) and an income-based waiver (heir family-group gross income below 400% FPL for the two years before the claim), the latter capped at $50,000 per qualifying heir and $100,000 per estate.
  • Recovery is deferred while a surviving spouse is living, and while there is a surviving child younger than 21 or a child of any age who is blind or permanently and totally disabled.
  • Three SJC decisions frame current practice: Daley/Nadeau, 477 Mass. 188 (2017), an irrevocable trust granting the applicant use and occupancy of the home does not make the trust's home equity countable. Kendall, 486 Mass. 522 (2020), MassHealth is bound by the 3-year MUPC statute of repose. Mason, 493 Mass. 148 (2023), a MassHealth real-estate lien is enforceable only if the property was sold during the member's lifetime.
  • 5-year (60-month) federal lookback fully applies to transfers made on or after February 8, 2006. The penalty period is the transferred value divided by the state's average monthly private-pay cost of nursing-facility care, so ask MassHealth for the figure in effect when you apply.
  • Senior Care Options (SCO): from 1/1/2026 every SCO enrollee must be enrolled in both Medicare Parts A and B and MassHealth Standard; members who lacked both Medicare parts moved to MassHealth Fee-for-Service on that date while keeping MassHealth Standard.
  • One Care moved from the CMS Financial Alignment Initiative demonstration to a D-SNP platform effective 1/1/2026, and under the MassHealth One Care contract each plan must operate as a fully integrated dual eligible special needs plan (FIDE SNP) with exclusively aligned enrollment.
  • HCBS waivers and PACE use a countable-income limit of 300% of the SSI federal benefit rate ($2,982/month for 2026) with a $2,000 individual asset limit, under 130 CMR 519.007.
  • Application: the SACA-2 (Application for Health Coverage for Seniors and People Needing Long-Term-Care Services, 03/26 edition), submitted online or printed and mailed or faxed to the MassHealth Enrollment Center (MEC), Central Processing Unit: P.O. Box 290794, Charlestown, MA 02129-0214 (fax 617-887-8799). Under-65 households not entering a nursing facility use a different form, the ACA-3, at a different address.
  • MassHealth Customer Service for seniors and long-term care: 800-841-2900 (TDD/TTY 711).

How This Guide Is Organized

This pillar covers everything Massachusetts families need to know about MassHealth for older adults, adults with disabilities, and people who need long-term care, organized around the questions families ask first.

Your Question Dedicated Guide
What's the income/asset limit? Eligibility & Income Limits
How much spending money does the resident keep? Personal Needs Allowance
What does MassHealth recover at death? Estate Recovery
How are married couples protected? Spousal Impoverishment
What's the spend-down pathway? Medically-Needy Spend-Down
What's SCO and One Care? SCO and One Care

This pillar landing summarizes each topic. The dedicated guides go deep with form numbers, fee schedules, and step-by-step worked examples.

The 1634 and Medically-Needy Framework

If you are working out whether a parent qualifies for MassHealth long-term care and their income looks "too high" on paper, Massachusetts almost certainly still has a path, and it is not the one out-of-state advisors often reach for. Because Massachusetts is a medically-needy state, an applicant over the income limit qualifies by meeting a deductible, computed as the excess monthly income multiplied by six, rather than by funding a qualified-income (Miller) trust the way an income-cap state requires. And because Massachusetts is a 1634 state, someone already receiving SSI is enrolled in MassHealth with no separate Medicaid application. An out-of-state planner who recommends setting up a Miller Trust for a Massachusetts client is applying the wrong state's rules and wasting legal fees on a device MassHealth does not use.

For how the spend-down actually works (the MNIL math, the six-month deductible, and worked examples), see Massachusetts MassHealth Medically-Needy Spend-Down.

Eligibility, Income, and Asset Limits

MassHealth uses different income standards depending on the coverage category. For community residents age 65 or older, MassHealth Standard uses 100% of the Federal Poverty Level, which MassHealth publishes, effective 3/1/2026, as $1,330/month for a household of one and $1,804/month for a household of two; applicants above that qualify through the medically-needy spend-down down to the deductible-income standard of $522/month for one person and $650/month for two. The asset limit is $2,000 for an individual, and MassHealth publishes a maximum home equity limit of $1,130,000, the same figure as the 2026 federal maximum. A 2025 federal law caps the Medicaid home equity limit at a flat $1,000,000 for non-agricultural homes beginning January 1, 2028.

For the full countable-vs-non-countable breakdown, the vehicle and burial exemptions, and irrevocable-trust mechanics, see Massachusetts MassHealth Eligibility & Income Limits.

Massachusetts Medicaid Personal Needs Allowance

A MassHealth long-term-care resident keeps a personal needs allowance of $72.80/month under 130 CMR 520.026, deducted from their income before the patient-paid amount owed to the facility is calculated. The same $72.80 applies to SSI recipients in long-term-care settings. MassHealth's published eligibility figures for long-term-care-facility residents list the same $72.80 in 2023, 2024, 2025, and 2026, so budget on that number. It sits well above the federal statutory floor of $30/month for an institutionalized individual under 42 U.S.C. 1396a(q)(2) and 42 CFR 435.725(c)(1). Bills to raise the allowance surface from session to session; track them on the Massachusetts Legislature website rather than budgeting on them.

For the patient-paid-amount mechanics, three worked examples, and the cross-state PNA comparison, see Massachusetts MassHealth Personal Needs Allowance.

Spousal Impoverishment and Spousal Refusal

Two Massachusetts rules dominate married-couple planning. First, Massachusetts is a 50% spousal-share state (130 CMR 520.016): the community spouse keeps the greater of half the couple's countable assets at the snapshot date (capped at the federal maximum $162,660) or the federal minimum $32,532, so with $200,000 combined, the community spouse keeps $100,000, not $162,660. This is the single most-miscommunicated fact in MA elder-law practice. Second, Massachusetts uses the federal income-first methodology required by the Deficit Reduction Act of 2005, and the institutionalized spouse keeps the $72.80 personal needs allowance while the rest of that spouse's income, after allowed deductions, goes to the facility as the patient-paid amount.

For the CSRA math, the snapshot and post-eligibility transfer rules, and worked examples, see Massachusetts MassHealth Spousal Impoverishment.

Estate Recovery

Chapter 197 of the Acts of 2024 narrowed MassHealth estate recovery to the federally mandated minimum (nursing-facility, home and community-based, and related hospital and prescription-drug costs) for deaths on or after August 1, 2024 (the broader pre-reform rules, recovering for all services received at age 55 or older, still apply to earlier deaths). Recovery is probate-only under M.G.L. c. 118E § 31, so assets passing outside the probate estate (joint tenancy with survivorship, tenancy by the entirety, life-estate remainders, revocable and properly drafted irrevocable trusts, and beneficiary-designated accounts) are out of reach, and a $25,000 auto-waiver protects modest probate estates with no application required. The deadline that matters most is procedural: a hardship waiver must be requested within 60 days of MassHealth's notice of claim, so an unopened envelope can cost a family the waiver entirely. Three SJC decisions frame current practice: Daley/Nadeau (an irrevocable trust granting the applicant use and occupancy of the home does not make the trust's home equity countable), Kendall (the 3-year MUPC statute of repose binds MassHealth), and Mason (a MassHealth real-estate lien is enforceable only if the property was sold during the member's lifetime).

For worked examples, the hardship-waiver categories, the full SJC-trilogy walkthrough, lien mechanics, and estate-recovery-unit specifics, see Massachusetts MassHealth Estate Recovery.

The 5-Year Lookback and Penalty Divisor

The federal 5-year (60-month) lookback under 42 U.S.C. § 1396p(c) applies fully to transfers made on or after February 8, 2006: a gift made within five years of a long-term-care application creates a penalty period, calculated by dividing the transferred value by the state's average monthly private-pay cost of nursing-facility care (the penalty divisor), so ask MassHealth for the figure in effect at the time of application. Massachusetts implements the same 60-month period at 130 CMR 520.019(B) for a nursing-facility resident. Common exceptions include transfers to a spouse, transfers to a blind or permanently and totally disabled child, and transfers of the home to an adult "caregiver child" who lived in the home for at least two years immediately before institutionalization and provided care that kept the parent out of an institution. A dedicated penalty-divisor and lookback guide, with the current transfer-penalty divisor and the exception categories, is forthcoming.

How to Apply for Massachusetts Medicaid

People age 65 or older, and people of any age who need long-term-care services, apply for MassHealth using the SACA-2 (Application for Health Coverage for Seniors and People Needing Long-Term-Care Services, 03/26 edition). It is a different form from the ACA-3 that under-65 households not entering a nursing facility use, and it goes to a different address. The SACA-2 can be completed and submitted online, or printed and mailed or faxed to the MassHealth Enrollment Center, Central Processing Unit (P.O. Box 290794, Charlestown, MA 02129-0214; fax 617-887-8799). MassHealth asks SACA-2 applicants for proof of income and assets. Two further rules apply to a nursing-facility resident rather than to the form itself: the 60-month look-back at 130 CMR 520.019(B), so gather five years of asset and bank records up front; and a determination of medical eligibility for nursing-facility services by MassHealth or its agent as a condition of payment (130 CMR 519.006(A)(2)), a clinical level-of-care review that runs alongside the financial one. For questions, call MassHealth Customer Service for seniors and long-term care at 800-841-2900 (TDD/TTY 711).

Where to Get Help

MassHealth Customer Service (Seniors and Long-Term Care) Answers questions about MassHealth eligibility, the SACA-2 application, and long-term-care coverage. 1-800-841-2900 (TDD/TTY 711) mass.gov/masshealth
MassHealth Enrollment Center (MEC), Central Processing Unit Mailing address: P.O. Box 290794, Charlestown, MA 02129-0214 (fax 617-887-8799) Receives and processes the SACA-2 long-term-care application for seniors and people needing LTC. mass.gov/apply-for-masshealth
MassHealth Estate Recovery Notices of claim, the $25,000 auto-waiver, and hardship-waiver requests (due within 60 days of the notice of claim) are handled by MassHealth. The contact details for the estate recovery unit are printed on the notice of claim itself, so keep that envelope. mass.gov/masshealth

Senior Care Options (SCO) and One Care

Massachusetts integrates Medicare and Medicaid for dual-eligibles through Senior Care Options (SCO) for older adults and One Care for younger adults with disabilities. Effective January 1, 2026, every SCO enrollee must be enrolled in both Medicare Parts A and B and MassHealth Standard; SCO members who lacked both Medicare parts were moved to MassHealth Fee-for-Service on that date while keeping MassHealth Standard coverage. One Care moved on the same date from the CMS Financial Alignment Initiative demonstration to a Dual Eligible Special Needs Plan (D-SNP) platform, and under the MassHealth One Care contract each plan must operate as a Medicare Advantage fully integrated dual eligible special needs plan (FIDE SNP) with exclusively aligned enrollment. Five entities hold signed 2026 One Care contracts with EOHHS: Commonwealth Care Alliance, Mass General Brigham Health Plan, Molina Healthcare, Point32Health (Tufts), and UnitedHealthcare. Participating plans change from year to year, so confirm your area's options before enrolling.

For 2026 plan options, enrollment timing, and the January 2026 transition mechanics, see Massachusetts MassHealth SCO and One Care.

PACE: All-Inclusive Care at Home

The Program of All-Inclusive Care for the Elderly (PACE) is a Medicare/Medicaid integrated program whose federal requirements sit at 42 CFR Part 460. To enroll, a person must be 55 or older, be determined by the state to need the level of care their state Medicaid plan requires for nursing-facility coverage, live in the PACE organization's service area, and meet any additional conditions in the PACE program agreement. In Massachusetts, PACE and the home- and community-based waiver pathways use a countable-income limit of 300% of the SSI federal benefit rate ($2,982/month for 2026) with a $2,000 individual asset limit, under 130 CMR 519.007. How a community spouse's assets are treated for a PACE applicant is an area MassHealth has been changing, so confirm the current treatment with MassHealth or an elder-law attorney before assuming any protection.

Long-Term Care: Nursing Home MassHealth

When an applicant needs nursing-facility level of care and qualifies through the institutional pathway, MassHealth pays the facility for room, board, and most medical care above the resident's patient-paid amount. That amount is the resident's income less the deductions allowed under 130 CMR 520.026, starting with the $72.80 personal needs allowance and including the maintenance-needs allowance deflected to a community spouse. For dual-eligibles, Medicare covers acute medical care and Medicare-eligible skilled-nursing days, while MassHealth covers the long-term custodial care Medicare does not.

For the level-of-care criteria, the full patient-paid-amount worksheet, and nursing-facility rate detail, see Massachusetts MassHealth Long-Term Care: Nursing Home.

What Makes Massachusetts MassHealth Different

Four things about MassHealth surprise families who arrive with advice built on another state's rules:

  • No Miller Trust. Massachusetts elects the optional medically-needy pathway of 42 CFR 435.301, so income over the standard is handled through a six-month deductible rather than a qualified-income trust.
  • A 50% spousal share, not 100%. The community spouse keeps half the couple's countable assets up to $162,660, not the full federal maximum.
  • Probate-only estate recovery, narrowed further in 2024. Chapter 197 of the Acts of 2024 limited recovery to the federally mandated minimum for deaths on or after August 1, 2024, and MassHealth cannot reach assets outside the probate estate at all.
  • A $72.80 personal needs allowance that has not moved. MassHealth's published long-term-care figures show the same $72.80 in 2023, 2024, 2025, and 2026.

What This Pillar Doesn't Yet Cover

This pillar landing summarizes the major topics with links to dedicated guides. Topics not yet built out that we plan to add:

  • Asset Limits, deep-dive on countable vs non-countable, vehicle exemption, burial planning, irrevocable trust mechanics
  • Penalty Divisor & Lookback, dedicated 5-year lookback walkthrough with 2026 transfer-penalty divisor, "otherwise eligible" doctrine, exception categories
  • Long-Term Care, nursing-home MassHealth deep dive with SACA-2 walkthrough, level-of-care criteria, NF rate detail
  • State Supplement Program, SSP categories, ALR/GAFC interaction with MassHealth
  • How to Apply, step-by-step SACA-2 walkthrough, document checklist, MEC operational specifics, processing timeline
  • Caregiver Pillar Massachusetts, paid-family-caregiver pathways, MassHealth PCA, GAFC, Frail Elder Waiver consumer direction

We add these as the editorial calendar permits. If you need any of the missing topics covered sooner, contact us through the contact page.

Frequently Asked Questions

Does MassHealth require a Miller Trust?

No. Massachusetts is a medically-needy state, not an income-cap state. Applicants with income above the standard qualify by meeting a six-month deductible, not by establishing a Miller Trust (Qualified Income Trust). Miller Trusts are a requirement of income-cap states, and Massachusetts is not one.

How much can my spouse keep if I go on MassHealth?

Massachusetts is a 50% spousal-share state (130 CMR 520.016). The community spouse keeps the greater of 50% of combined countable assets at the snapshot date (capped at the federal maximum of $162,660) or the federal minimum ($32,532). With $200,000 in combined assets, the community spouse keeps $100,000, not $162,660.

Will MassHealth take my house when I die?

Massachusetts pursues probate-only estate recovery under M.G.L. c. 118E § 31, and MassHealth cannot recover from assets outside the member's probate estate, so joint tenancy with survivorship, life-estate remainders, trusts, and beneficiary-designated accounts are not subject to recovery. The $25,000 auto-waiver also protects modest probate estates automatically. Chapter 197 of the Acts of 2024 narrowed recovery to nursing facility, home and community-based, and related hospital and prescription-drug services for deaths on or after August 1, 2024.

How long does MassHealth take to approve a long-term care application?

Timing depends on how complete your file is. MassHealth asks SACA-2 applicants for proof of income and assets, and a nursing-facility applicant must also be found medically eligible for nursing-facility services under 130 CMR 519.006(A)(2), so a missing bank statement or a pending level-of-care determination is what usually stretches the wait. For the status of a filed application or current expected timing, call MassHealth Customer Service for seniors and long-term care at 1-800-841-2900 (TDD/TTY 711).

Does the $25,000 estate recovery auto-waiver apply automatically?

Yes, for dates of death on or after May 14, 2021. MassHealth waives recovery when the probate petition certifies, under penalties of perjury, that the estate's total assets are valued at $25,000 or less. No formal waiver application is required.

If MassHealth Denies or Cuts Your Coverage

Massachusetts gives you 60 days, not 90. The Board of Hearings must receive your completed, signed fair hearing request within 60 calendar days from the date you received the MassHealth notice of action (130 CMR 610.015(B)(1)), and it measures that deadline against the date it receives your request, not the date you mail it. Federal law guarantees that right whether the dispute is about eligibility or about a specific service being reduced or ended. The 90 days at 42 CFR 431.221(d) is a ceiling on what a state may allow, not a floor you are entitled to, and Massachusetts sets its own window at 60 days inside it.

There is a second, earlier deadline that matters more if you are already enrolled. Your assistance continues until the Board decides the appeal if your request reaches it before the implementation date of the action, and it is reinstated if the request arrives within 10 days of the notice's mailing., Miss both and you may still appeal, but coverage can stop in the meantime.

If the denial came from a managed care plan (an ACO, MCO, SCO, or One Care plan) rather than MassHealth itself, that 60-day clock is not the one that governs you: you exhaust the plan's internal appeal first, and the Board must then receive your hearing request within 120 days of the plan's final internal appeal decision. See Massachusetts Medicaid Appeals and Fair Hearings for how to file and what happens after a decision.

Keeping MassHealth Coverage Once You Have It

Coverage is not permanent. Eligibility is re-checked on a recurring cycle, and missing that step is one of the most common ways people lose coverage they still qualify for.

MassHealth must first try to renew your coverage automatically from information it already holds, and may only request documents if it cannot. If it does need paperwork, it must send a renewal form and give you at least 30 days from the date of the form to return it. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Massachusetts may offer the same windows but is not required to, so ask MassHealth what applies to you.

If coverage does close because a form went unreturned, that is not the end of it. Federal rules require the agency to reconsider your eligibility without a new application if you return the renewal form within 90 days of the termination (required for MAGI-based coverage; a state option otherwise).

Keep your mailing address current, open anything from MassHealth, and return the form by the deadline printed on it. See Massachusetts Medicaid Recertification and Renewal for the full cycle and how to recover closed coverage.

The Bottom Line

Massachusetts MassHealth is one of the more consumer-friendly Medicaid programs in the country, but only with informed planning. Probate-only estate recovery, the $25,000 auto-waiver, the Daley/Nadeau irrevocable-trust framework, and the medically-needy spend-down (no Miller Trust required) let Massachusetts families preserve substantial assets while qualifying for high-quality long-term care.

But the same landscape has traps: the 50% spousal-share rule misleads families expecting the federal maximum; the 60-day hardship-waiver deadline on an estate-recovery notice of claim runs out on families who set the envelope aside; and the 2028 federal home-equity ceiling will pull the current $1,130,000 limit down to a flat $1,000,000.

Core action items for Massachusetts families:

  1. Plan early. The five-year lookback means asset-protection trusts must be established years before institutionalization.
  2. Get the right advisor. Massachusetts is a 50%-share, income-first, 1634, probate-only state, and planners trained on an income-cap state's rules may give wrong advice.
  3. Don't ignore the notice of claim. A hardship waiver has to be requested within 60 days of it.
  4. Use the $25,000 auto-waiver. Modest probate estates are protected automatically; make sure the probate petition self-certifies under penalties of perjury.
  5. Don't budget on a PNA increase. Plan on $72.80 until MassHealth's published figures say otherwise.
  6. Verify SCO/One Care plan options for 2026. The January 2026 transition affects coverage mechanics and provider networks.

For each major topic, see the dedicated guides linked above. For complex planning, engage a Massachusetts NAELA-affiliated elder-law attorney.

Learn More

MedicaidMedicaid by State: Eligibility, Coverage, and How to ApplyMedicaid works differently in every state, from who qualifies to what's covered and how to apply. See what varies and jump to your state's full guide. MedicaidMassHealth Eligibility & Income Limits2026 MassHealth eligibility for seniors and people with disabilities: income limits, asset limits, the medically-needy spend-down, and savings programs. MedicaidHow to Apply for MassHealthHow to apply for MassHealth (Massachusetts Medicaid) in 2026: the online route for people under 65 and the SACA-2 application for seniors and long-term care. MedicaidMassachusetts Medicare Savings ProgramsMassachusetts Medicare Savings Programs in 2026: income limits up to 225% FPL, no asset test, and how to apply through MassHealth for QMB, SLMB, and QI. MedicaidMassHealth Estate RecoveryMassachusetts Medicaid estate recovery in 2026: the 2024 LTC Act narrowing, the $25,000 auto-waiver, three hardship waiver categories, and probate-only scope. MedicaidMassHealth Spousal ImpoverishmentMassachusetts Medicaid spousal impoverishment in 2026: the 50% CSRA rule, MMMNA $2,705.00-$4,066.50, income-first methodology, and Freiner spousal refusal. MedicaidMassHealth 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 Personal Needs AllowanceMassachusetts Medicaid personal needs allowance in 2026: the $72.80 MassHealth PNA under 130 CMR 520.026 and how it fits the patient-pay calculation. MedicaidMassHealth SCO & One CareMassachusetts Medicaid SCO and One Care changed on 1/1/2026: SCO now requires Medicare Part A and B, and One Care moved to a D-SNP platform. Plans and steps.

Find personalized help navigating MassHealth eligibility, applying with the SACA-2, or planning around estate recovery 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.