With the right planning, a person can become eligible for MassHealth (Medicaid in Massachusetts) to help with long-term care costs. This guide explains current MassHealth eligibility requirements and planning strategies.
Who is eligible for MassHealth?
Massachusetts residents who meet income and asset limits. Eligibility varies by program type (Standard, CommonHealth, Senior Buy-In).
Is MassHealth Medicaid?
Yes. MassHealth is Massachusetts’ name for Medicaid the federal and state health insurance program for low-income individuals and families.
MassHealth eligibility requirements (2026):
- Asset limit: $2,000 for individuals, ~$148,000 for married couples
- Income limit: Varies by program (typically ~$1,732/month for individuals)
- Age/disability requirements vary by program type
The Heritage Law Center helps Massachusetts families qualify for MassHealth through proper asset protection planning. Below, we explain current eligibility rules and strategies.
What is MassHealth (Medicaid)?
Medicaid was created by Congress in 1965 to help with insurance coverage and protect seniors from the costs of medical care, regardless of their income, health status, or past medical history, reports Kiplinger in a recent article “How to Restructure Your Assets to Qualify for Medicaid.” Medicaid is a means-based program, with broad federal parameters, that is run by the individual states. Eligibility criteria, coverage groups, services covered, administration, and operating procedures are all managed by each state.
For people 65 years of age and older who are being faced with the increasing costs and need for long-term care, MassHealth has become a lifesaver. It covers the costs of a long-term nursing home stay or home health care that aren’t covered by Medicare. Here are the MassHealth eligibility requirements for seniors and some estate planning tools that can protect their assets.
MassHealth Eligibility for Seniors (2026 Guidelines)
MassHealth eligibility income limits (2026):
– MassHealth Standard (for seniors/disabled): Individual income up to ~$1,732/month
– Senior Buy-In: Allows seniors to work while receiving MassHealth
– Income over limits may still qualify with a Miller Trust
Masshealth asset limit over 65 (2026):
– Individual: $2,000 in countable assets
– Married couple (both applying): $3,000 combined
– Married couple (one applying): ~$148,000 for community spouse
What counts as assets?
– Bank accounts, investments, retirement accounts
– Second homes, rental property
– Vehicles beyond one car
What doesn’t count?
– Primary residence (under certain equity limits)
– One vehicle
– Personal belongings, household items
– Life insurance under $1,500 face value
– Prepaid burial/funeral
The Heritage Law Center helps families navigate these complex MassHealth requirements.
How to Qualify for MassHealth: Step-by-Step
Follow these steps:
1. Determine Your Program
– MassHealth Standard – For low-income seniors/disabled
– Senior Buy-In – For working seniors
– CommonHealth – For disabled individuals with higher income
2. Check Income Eligibility
– What is the maximum income to qualify for MassHealth? Generally ~$1,732/month for individuals (2026)
– Income includes Social Security, pensions, wages
3. Check Asset Eligibility
– Do I qualify for MassHealth? You must have under $2,000 in countable assets (individual)
4. Apply Through MassHealth
The Heritage Law Center assists with the complex MassHealth application process and can implement strategies to help you qualify if you’re currently over the limits.
Need MassHealth planning? Our elder law attorneys specialize in MassHealth planning throughout Massachusetts.
Irrevocable trust: This type of trust can’t be changed or dissolved after they’re created. You may transfer most or all of your assets into this trust, including your home, and maintain the right to live in your home. This trust offers asset protection against taxes and creditors while also protecting your eligibility for certain government benefits, like MassHealth.
If you put assets in the trust that generate income like investments, you can still get that income to use. Upon your death, assets are transferred to beneficiaries, according to the trust documents.
Annuities: For a married couple, if only one spouse applies for MassHealth, annuities can help reduce countable assets for the applying spouse. In this instance, a lump sum is paid to the insurance carrier, and that carrier then makes a monthly payment to the non-applying spouse, thereby converting countable assets into non-countable income.
Pooled income trust, if you qualify as disabled: This is another irrevocable trust where your “surplus income” is deposited. Income is pooled together with the income of others. The trust is managed by a non-profit charitable organization, which acts as a trustee and makes monthly disbursements to pay expenses for the individuals participating in the trust. When you die, any remaining funds in the trust are used to help other disabled persons.
Spend down your assets: To spend down appropriately, you must spend assets on your needs, including medical care, in-home supports like personal care and cleaning, home repairs, car repairs, eyeglasses, hearing aids, and mobility aids. You can also pay bills/debts like credit cards, mortgage payments, taxes, and car payments even if those costs are owed by your spouse. Assets can also be used to pay for burial and funeral expenses in advance.
Mistakes Can Be Costly
For instance, your home’s value (up to a maximum amount) is exempt, as long as you still live there or will be able to return. Transferring assets to other people, typically family members, is a risky strategy. There’s a five-year look back period and if you’ve transferred assets, you may not be eligible MassHealth for five years. If the person you transfer assets to has any personal financial issues, like creditors or divorce, they could lose your property.
Planning in advance is the best means of protecting yourself and your spouse from the excessive costs of long-term care. To learn more about MassHealth eligibility and protecting your assets, contact us today to set up a free, confidential consultation.
Common MassHealth Eligibility Questions
Is MassHealth private insurance?
No. MassHealth is public health insurance (Massachusetts Medicaid), not private insurance.
What type of insurance is MassHealth?
MassHealth is government-sponsored health insurance specifically, it’s Massachusetts’ Medicaid program providing coverage for eligible low-income residents.
Masshealth income guidelines for over 65: Seniors 65+ generally qualify if income is below ~$1,732/month (2026) for MassHealth Standard, though Senior Buy-In allows higher income.
Mass health requirements: Must be Massachusetts resident, meet income/asset limits, and qualify for specific program based on age, disability, or family status.
Medicaid planning Massachusetts: The Heritage Law Center helps families restructure assets to meet MassHealth requirements while protecting wealth for spouses and heirs. Our asset protection strategies can help you qualify.