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MassHealth as secondary insurance

Your family member may qualify for MassHealth on top of their private insurance.

MassHealth plans don't all depend on having low income.

Your family member may qualify for special MassHealth plans for people with certain types of disabilities.

This is key! You can save money and get extra services.

If you have the right MassHealth plan, you can save money and get extra services that can make your life easier. 

Click the box below to look into the MassHealth options. Find one that may be a good fit.

Read about the different types of MassHealth plans so you can decide which one is right for your family.

image of MassHealth options: Standard, CommonHelath and Kaileigh Mulligan


There are 3 options:

1. MassHealth Standard

  • This option is for you if your family income is less than 150% of the federal poverty level.

  • To find your family's income level, use this online calculator.

  • If you qualify, this can be your primary insurance plan.

  • But if you also have private health insurance, this can be a supplemental (secondary) plan.

  • Even if you have private insurance, you may be able to get this for free.

  • This will pay for deductibles, co-payments and other extra costs not covered by your private insurer. But, you must use a doctor or provider who takes MassHealth.

2. MassHealth CommonHealth

  • This option is for you if your family income is greater than 150% of the federal poverty level and you have a child with a disability.

  • To find your family's income level, use this online calculator.

  • If you qualify, this can be your primary insurance plan.

  • But if you also have private health insurance, this can be a supplemental (secondary) plan.

  • This is a great way to supplement private health insurance coverage for a child with a disability.

  • You pay a monthly fee (called a 'premium') based on your family income.

3. Kaileigh Mulligan program

This option is for you if your child:

  • has a severe disability,

  • is living at home, and

  • needs skilled nursing care or technology

There are no income or asset requirements.


Ask your child's hospital social worker or a Department of Public Health case manager how to apply.

 

image of exclamation point and text: If your child is covered through the Kaileigh Mulligan program, you can't renew your coverage online. You have to use the paper form when you renew.

Sources: Autism Consortium, Federation for Children with Special Needs, Autism Insurance Resource Center

Most families who have private insurance AND a family member with disabilities can qualify for MassHealth CommonHealth, which could make your family eligible for Premium Assistance.

Premium Assistance:

  • This is a program that lets you pay a lower premium, or none at all.

  • You must apply to this program separately.

To apply for Premium Assistance call 1-800-862-4840 extension 7

To apply for MassHealth CommonHealth:

Click the buttons below and follow the step-by-step instructions. We'll show you how to fill out the application and the disability supplement forms:

What you can do to apply or renew:

Go to the MassHealth website Application for Families and People with Disabilities. It will tell you how to apply in any of these ways:

Online

  • This is the fastest way to apply

  • Visit MAhealthconnector.org, create an account, and fill out the application

By Mail

  • Click the link at the bottom of the page to download a PDF of the MassHealth application

  • Fill it out and mail it to:

    • Health Insurance Processing Center

    • P.O. Box 4405

    • Taunton, MA 02780

    • Or fax: 1-857-323-8300

By Phone

  • Call MassHealth at 1-800-841-2900 (TTY: 1-800-497-4648)

  • This is an automated phone system. Listen carefully, and be patient!

In Person

Tips on filling out the form:

  • Fill it out completely

  • Fill out the Supplements if they apply to you. If your family member is over the age of 18 and you do not have guardianship, click the button below to download a copy of the Authorized Representative Form that you can include with your application.

  • If you fill out any extra pages or forms, attach them to the application when you send it in

If your family member gets Supplemental Security Income (SSI) in Massachusetts, they automatically qualify for MassHealth. Learn more in the Exceptional Lives SSI Guide.

Need more help?

If you need more help with this process, call any of these other helpful resources:

  • HealthCare For All’s free Health Hotline:  Call  1-800-272-4232

  • The Family-to-Family Health Information Center :You can get free, confidential help navigating the MassHealth system. Staff can help you through the process of applying, and help you understand the coverage options. This service is offered by Mass Family Voices, a project of the Federation for Children with Special Needs.

  • The UMass Disability Evaluation Services (DES) Help Line:Call1-888-497-9890

Sources: Commonwealth of MA, MassHealth, MA Health Connector

What you can do:

1. Click the link at the bottom of the page to download a PDF of the MassHealth Disability Supplement Form (Child)

2. If you are not the parent or legal guardian, click the link at the bottom of the page to download a PDF of the MassHealth Authorized Representative Designation Form. This will give you permission to sign other forms for your family member.

3. Read the directions carefully and give as much detail as possible. Use extra sheets of paper if you need more room to explain, and attach them to the application.

If your family member needs urgent medical or psychological services right away and you need this processed quickly, attach a letter to the front of the disability supplement explaining your situation. Include this sentence: 'I request that DES expedite this disability supplement so that my family member can access the care they need to stay safe and healthy in the community.'

What to do next:

  1. Make a copy of the completed Disability Supplement form and keep for your records

  2. Mail the form to the address below. Since this is an important form, try to mail it from the post office and ask for a return receipt (this is your proof that you mailed the form). Mail everything to:

    • Disability Evaluation Services

    • UMass Medical DES

    • P.O. Box 2796

    • Worcester, MA 01613-2796

  3. MassHealth will send you a decision letter within 90 days of getting the form. You can call the MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997) for more information

Source: MassHealth

What you can do:

  1. Click the link at the bottom of the page to download a PDF copy of the form

  2. Read the directions carefully

  3. Fill it out completely, and give as much detail as possible

  4. Use extra sheets paper if you need more room to answer any of the questions. Attach them to the application

  5. Fill out other forms as needed and attach them

If your family member needs urgent medical or psychological services right away and you need this processed quickly, attach a letter to the front of the disability supplement explaining your situation. Include this sentence: 'I request that DES expedite this disability supplement so that my family member can access the care they need to stay safe and healthy in the community.

Source: MassHealth

Click the link below to download a PDF of the MassHealth Paper Application.

 

Source: MassHealth