Understanding Medicaid eligibility in Massachusetts for 2026 can feel overwhelming, especially when income limits, rules, and programs change every year.
Many residents are unsure whether they still qualify, how income is counted, or whether small raises or new benefits could affect their coverage.
Massachusetts Medicaid, known as MassHealth, covers millions of residents, including children, working adults, pregnant women, seniors, and people with disabilities.
In 2026, updated income guidelines and program adjustments mean some households may newly qualify, while others need to double-check their eligibility.
You’ll learn what changed in 2026, how income limits compare to 2025, who qualifies, how to apply, and what to expect after you apply.
New income guidelines for MassHealth take full effect in March 2026.
What Changed for Massachusetts Medicaid in 2026
Several updates took effect in 2026 that directly affect MassHealth eligibility:
- Federal Poverty Level (FPL) amounts increased for 2026, raising income limits across most MassHealth programs
- Monthly income thresholds increased slightly for adults, families, and children
- Eligibility rules remain stable for Medicaid expansion adults, helping maintain coverage continuity
- MassHealth programs for seniors and people with disabilities continue to use separate income and asset rules
These updates are important because even small income limit increases can help families who were just over the cutoff in 2025 qualify in 2026.
Massachusetts Medicaid Income Limits 2026 (With 2025 Comparison)
MassHealth income limits are based on gross monthly income and household size. Below is a simplified comparison showing 2026 limits first, followed by 2025 limits, so you can clearly see the change.
2026 MassHealth Income Limits (Monthly)
| Eligibility Group | Single Adult | Family of 3 | Income Standard |
| Adults (19–64, no Medicare) | ~$1,750 | ~$2,980 | ~138% FPL |
| Parents / Caretaker Relatives | ~$1,750 | ~$2,980 | ~138% FPL |
| Children (0–18) | ~$3,350 | ~$5,700 | ~300% FPL |
| Pregnant Women | ~$3,350 | ~$5,700 | ~300% FPL |
| Seniors (65+) / Disabled (non-MAGI) | ~$1,275 | ~$1,725 | SSI-related |
| Long-Term Care (Nursing Home) | ~$2,900 | ~$5,800 | 300% SSI limit |
2025 MassHealth Income Limits (Monthly)
| Eligibility Group | Single Adult | Family of 3 |
| Adults (19–64) | ~$1,700 | ~$2,900 |
| Parents / Caretaker Relatives | ~$1,700 | ~$2,900 |
| Children (0–18) | ~$3,250 | ~$5,550 |
| Pregnant Women | ~$3,250 | ~$5,550 |
| Seniors / Disabled | ~$1,255 | ~$1,695 |
| Long-Term Care | ~$2,830 | ~$5,660 |
What this means:
Income limits increased modestly in 2026, especially for families with children and pregnant women. If you were slightly over the limit in 2025, you may now qualify.
What Is Medicaid Eligibility in Massachusetts?
Medicaid eligibility in Massachusetts determines whether you can receive health coverage through MassHealth, the state’s Medicaid program.
MassHealth uses two main systems:
- MAGI-based eligibility for children, pregnant women, parents, and most adults under 65
- Non-MAGI eligibility for seniors and people with disabilities, which includes income and asset rules
For most working-age adults and families, eligibility depends mainly on household size and monthly income, not assets.
Who Qualifies for MassHealth in 2026
MassHealth eligibility applies to many different life situations, including:
- Adults ages 19–64 with low or moderate income
- Parents or caretakers raising children
- Children under 19, even if their parents earn more
- Pregnant women needing prenatal and postpartum care
- Seniors age 65 and older
- People with disabilities or long-term medical needs
Because MassHealth has multiple coverage types, many people qualify even if they assume they don’t.
Step-by-Step: How to Check Your Eligibility
Step 1: Determine Your Household Size
Include yourself, your spouse, and dependents you claim on taxes.
Step 2: Calculate Gross Monthly Income
Count income before taxes, such as:
- Wages or self-employment income
- Social Security or disability benefits
- Unemployment or retirement income
Step 3: Identify Your Eligibility Group
Your category (adult, child, pregnant, senior, disabled) affects the income limit.
Step 4: Compare With 2026 Income Limits
Use the 2026 table above to see where your income falls.
Step 5: Apply Through MassHealth
Applications can be submitted online, by mail, or with help from a MassHealth enrollment center.
Important tip: MassHealth reviews eligibility regularly. Report income changes promptly to avoid coverage interruptions.
What MassHealth Covers vs What It Doesn’t
| Covered Services | Not Typically Covered |
| Doctor visits | Cosmetic procedures |
| Hospital care | Non-medical travel |
| Prescription drugs | Elective treatments |
| Mental health services | Private duty nursing |
| Maternity care | Most cosmetic dental work |
Coverage details may vary by plan and eligibility type.
Important Rules, Limits, and Requirements
- You must be a Massachusetts resident
- Citizenship or an eligible immigration status is required
- Income is usually counted monthly, before taxes
- Asset limits generally apply only to seniors and long-term care cases
- Failure to report changes can result in loss of coverage
Many denials happen due to paperwork issues, not actual ineligibility.
What Happens After You Apply
After submitting a MassHealth application:
- Most decisions are made within 30–45 days
- You may be asked to verify income or residency
- Coverage can sometimes be retroactive
- If denied, you will receive a written notice with appeal rights
Appeals are common and often successful when documentation is clarified.
Helpful Tips and Alternatives
- Apply even if your income is close to the limit
- Children often qualify even when adults do not
- If denied, check eligibility for subsidized Health Connector plans
- Free enrollment help is available through certified MassHealth assisters
FAQs
When do the 2026 income limits actually start?
MassHealth typically adopts new federal poverty guidelines on March 1, 2026. Applications submitted in January or February generally use 2025 limits. If you are denied early in the year, re-applying after March 1st may result in approval as limits increase.
Did the asset limit for seniors increase for 2026?
No. As of early 2026, the countable asset limit for seniors (65+) remains $2,000 for an individual and $3,000 for a couple. While advocates have proposed increases, no official legislation has raised this cap for the current year.
Is the ConnectorCare Plan Type 1 ending for immigrants?
Yes. Effective January 1, 2026, ConnectorCare Plan Type 1 is discontinued for certain non-citizens with income under 100% FPL who are ineligible for MassHealth. Affected members should review their notices for alternative options or Health Safety Net eligibility.
Do I still need to renew my coverage this year?
Yes. The temporary pandemic protections have ended. In 2026, MassHealth conducts regular annual renewals. Watch for a blue envelope or digital notice and respond immediately to verify your household income to prevent a gap in your coverage.
Can MassHealth pay for past medical bills?
Yes. If you were eligible during the three months before your application date, MassHealth can pay for covered medical services received during that retroactive period. You must specifically request this coverage on your application.
Does MassHealth cover dental care in 2026?
Yes. MassHealth Standard and CommonHealth continue to provide comprehensive dental benefits for adults and children in 2026, including cleanings, exams, fillings, and dentures. specialized services like crowns may require prior authorization.
Final Takeaway
Massachusetts Medicaid eligibility in 2026 reflects updated income guidelines designed to keep healthcare accessible for residents.
While the changes from 2025 are moderate, they may allow more families, children, and pregnant women to qualify for MassHealth coverage.
If you are unsure about eligibility, applying is often worthwhile. Understanding your income category, reporting changes correctly, and following up when needed can help you maintain the healthcare coverage you and your family depend on.
