The Basic MassHealth plans

There are 3 main options:

image with three MassHealth options: Standard, CommonHealth and Kaileigh Mulligan.

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.

If you have the right MassHealth plan, you can save money and get extra services that can make your life easier. You can reapply at any time to see if your family member qualifies for MassHealth Standard or MassHealth CommonHealth.

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. (See below to learn more.)

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.

Getting help with premiums:

  • If your family member qualifies for CommonHealth, you may have to pay a monthly fee called a premium.

  • The amount is based on your family income.

  • If you're worried that this plan is not worth the cost, see if you can get Premium Assistance. It's a program that lets you pay a lower premium, or none at all.

  • To apply for Premium Assistance, call 1-800-862-4840 ext. 7

There are other special plans for children with specific needs. See the next section in the menu.

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

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