What is the Maximum Income to Qualify for MassHealth?

MassHealth is a joint state and federal program that pays for health care for certain low and moderate-income households. It also provides help paying for insurance premiums. The program has strict financial eligibility requirements, including a maximum limit on countable assets.

Generally speaking, almost all income is countable for MassHealth purposes. This includes wages from an employer, tips and bonuses, self-employment earnings after qualifying deductions (Schedule C losses) and IRA withdrawals and stock dividends. Some nonworking incomes are disregarded, such as Aid & Attendance payments, Holocaust restitution payments and veteran’s benefits. If you’re applying for Medicaid, it’s important to update your income regularly throughout the year. It’s easy to miss the deadline, especially if you have a seasonal or fluctuating work schedule or more than one job. You can use an online income calculator to estimate your annual income and expenses and see if you’re eligible for coverage.

The upper income levels change each year based on changes to the federal poverty level. MLRI’s 2023 MassHealth Desk Guide shows the upper income levels, as monthly and yearly figures, for both the MassHealth programs and the Medicare Savings Program.

MassHealth Income Standards

Family SizeMassHealth Income Standards
For each additional person add$133$1,596

MassHealth Asset Limit

If someone is attempting to apply for long-term care Medicaid, they need to be certain that they meet the income and asset eligibility requirements. If not, the application may be denied or delayed. There are some techniques, such as gifting, that can be used to help reduce an individual’s assets and lower their value so they meet the eligibility requirements. However, this needs to be done carefully and strategically. There are penalties for transferring assets for less than fair market value within five years of applying for Nursing Home Medicaid or the HCBS Waiver, and these transfers could also have tax implications.

An individual’s countable assets are calculated by assessing all of their financial resources, including cash, bank accounts (checking and savings), investments, stocks and bonds, IRAs, certificates of deposit, and other valuable items. Nonworking income is also taken into account, such as unemployment compensation, rental income, alimony, child support, dividends and interest payments, Social Security benefits and VA pensions.

In 2023, a single applicant for MassHealth Standard is allowed to have up to $2,000 in countable assets. In addition, a nursing home resident is limited to about $148,620 in countable assets combined with their spouse. However, a person’s home is exempt from this limit in most instances, as long as they live in the house and have an intent to return. They can also keep a vehicle, prepaid funeral plans and personal belongings.

Nonworking Income MassHealth
What is the Maximum Income to Qualify for MassHealth? 1

Nonworking Income

In most cases, all income is counted when determining eligibility for MassHealth, though there are some exceptions. For example, the nonworking income of a married couple applying for Regular Medicaid / Aged Blind and Disabled is excluded when calculating their eligibility. However, this does not apply when applying for Institutional (nursing home) or Home and Community Based Services through a MassHealth waiver.

The income of working individuals is counted, but there are several deductions that can be taken from wages. These include health and life insurance premiums, employer-paid parking or mileage, union dues, personal expenses such as haircuts or clothing, and the cost of household help.

Nonworking income that is not excluded from the calculation includes unemployment compensation, investment interest, dividends, Social Security retirement benefits, and IRA withdrawals. Other sources of nonworking income include cash assistance from the Department of Transitional Assistance, the federal Supplemental Nutrition Assistance Program (SNAP), and the veterans’ Aid & Attendance and Holocaust restitution payments. In addition, the program may use other sources of income verification such as affidavits, information matches with state and federal agencies, and pay stubs.

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