How do I apply for MassHealth?

Medicaid in Massachusetts is called MassHealth: There are many different types of MassHealth. Eligibility for a particular MassHealth program is determined by family income and family size, as a percent of the federal poverty level and whether or not you have a family member with a disability. Disability is determined by the federal criteria on the Social Security Administration (SSA) website.

To read the childhood listing for Autism Spectrum Disorders, go to: www.socialsecurity.gov/disability/professionals/bluebook/ChildhoodListings.htm Click on 112.00 Mental Disorders and scroll down to 112.0

If you live in another state, you will find the list of state Medicaid programs at 64.82.65.67/medicaid/states.html 

Applying for MassHealth:

There is a single application for all the MassHealth programs. It’s called an MBR (medical benefit request form). Call 1-888-665-9993 (TTY: 1-888-665-9997 for people with partial or total hearing loss) for an application or download it from the MassHealth website at: www.mass.gov/masshealth. On the left hand side, click on: “Individuals, Children and Families.” Then click on “How to Apply” and you’ll see the download for the MBR. You must also fill out the Child Disability Supplement and submit that with you MBR. To do so, go to www.mass.gov and type child disability supplement in the search box. 

Types of MassHealth:

MassHealth Standard: If your family income is less than 150 percent of the federal poverty level, your child will be eligible for MassHealth Standard. Even if you have private health insurance, your child can also have MassHealth Standard at no additional cost to your family. MassHealth Standard will pay for any deductibles, co-payments and other costs not covered by your private insurer.

MassHealth CommonHealth: If your family income is greater than 150 percent of the federal poverty level and you have a child with a disability (as defined by the SSA federal criteria), even if you have private health insurance, your family may choose to buy into the MassHealth system. This type of MassHealth is called CommonHealth.  CommonHealth is a way to supplement private health insurance coverage for a child with a disability. You will pay a premium based on your family income. The more you make, the more you pay. If you have many out-of-pocket expenses, such as deductibles, co-payments (for doctors' visits, medications, hospitalizations), need diapers (for children older than 4) or durable medical equipment and have reached service limits (maxed out visits for physical, speech and language or occupational therapy) through your primary health insurer, CommonHealth is a way to ensure that your child receives all the necessary health services.

MassHealth Standard/CommonHealth Premium Assistance: This program provides financial assistance to families who have a family member who receives MassHealth Standard or MassHealth Commonhealth and who pay private health insurance premiums. In order to be eligible for Premium Assistance:

  • You must have at least one family member on MassHealth Standard or MassHealth Commonhealth.
  • You must pay the premiums on your private health insurance. If your employer pays your entire premium, you are not eligible for this benefit.
  • Your private insurance must offer the Commonwealth of Massachusetts required benefits. These include: early intervention, mental health and substance abuse treatment, hospice, other inpatient and outpatient services, physician, surgical, laboratory, radiological and maternity services, durable medical equipment, home health care services, ambulance transport and special formulas for people who need low protein foods.
  • Family income is not taken into account for program eligibility.

To apply for this program, call 1-800-862-4840 and press 1. Be sure to say you are calling about the MassHealth Standard/CommonHealth Premium Assistance Program for a family member with a disability.

This information was provided by the Massachusetts Family-to-Family Health Information Center, a project of Mass Family Voices @ Federation for Children with Special Needs, and developed with funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Division of Services for Children with Special Health Needs, grant number H84MC08005.  The MA Family-to-Family Health Care Information and Education Center specializes in helping people understand and access the MassHealth system. For more information, questions or problems, call the MA Family-to-Family Health Information & Education Center at 1-800-331-0688, Ext. 210, e-mail This e-mail address is being protected from spam bots, you need JavaScript enabled to view it   or visit www.massfamilyvoices.org.