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MassHealth Health Insurance
for Worcester, Massachusetts

AN OVERVIEW

MassHealth is a program that provides free health insurance to eligible low and moderate-income families and individuals. MassHealth health insurance pays for medical treatment provided by private doctors, clinics, HMOs, hospitals, and pharmacies. Most children in Massachusetts whose parents cannot afford to pay for medical care are eligible for free health insurance for children through MassHealth. Immigrants, including undocumented immigrants, are eligible for certain health insurance benefits without fear of deportation.


For more information, click on the questions below to go to the main MassHealth page on WorcesterResources.org:

What is MassHealth?

MassHealth is a state health insurance program, funded by both the state and federal governments, that pays medical bills for eligible low- and medium-income families and individuals in Massachusetts. Medicaid is one part of MassHealth

Am I eligible for MassHealth benefits?

To receive MassHealth benefits, you must be a low- to middle-income Massachusetts resident and must meet certain general and financial eligibility requirements.

Eligibility Check

The MassHealth Eligibility Check is an easy way for you to find out if you are likely to qualify for MassHealth benefits. By answering questions online about your family, your living situation, your job status, and your income you will see the results of the eligibility check right away, on your computer screen.

What MassHealth benefits are available?

The MassHealth program pays for all or some of a member’s health insurance and health care services. Services and costs vary depending on your type of coverage.

How do I apply for MassHealth?

To apply for MassHealth, you should call the MassHealth Enrollment Center at 1-888-665-9993 (or TTY: 1-888-665-9997 for the deaf and hard of hearing) to request an application. You can also get an application online at the MassHealth web site and from various Worcester community health centers.

How do I use my MassHealth benefits?

Once you have been approved for MassHealth, you will receive an enrollment package explaining how to choose a health plan and a primary care doctor. You will also receive your MassHealth card which you must show whenever you need medical care.

MassHealth coverage types

MassHealth includes several coverage types with different rules for each coverage. The coverage types are:

  • MassHealth Standard: comprehensive health insurance, including long-term-care, for low-income Massachusetts residents including eligible parents with children under 19 years of age, pregnant women, children up to 19 years of age, the elderly, and people with disabilities.

  • MassHealth CommonHealth: complete coverage similar to MassHealth Standard, for eligible adults with disabilities and children with disabilities who cannot get MassHealth Standard because their incomes are too high.

  • MassHealth Family Assistance: health insurance with most of the services of MassHealth Standard, for children under 19 and people with HIV who are not eligible for MassHealth Standard or CommonHealth; also health insurance premium assistance for certain employed adults.

  • MassHealth Basic: a full range of health care benefits or premium assistance for EAEDC recipients and low-income Department of Mental Health clients who are long-term unemployed.

  • MassHealth Limited: emergency medical coverage for undocumented noncitizens whose immigration status makes them ineligible for other MassHealth programs.

  • Medicare Buy-In programs: programs that pay all or part of Medicare health insurance expenses for eligible low-income Medicare recipients.

  • MassHealth Prenatal: short-term outpatient prenatal care for pregnant women who have applied for MassHealth and are waiting for eligibility approval.

  • MassHealth Essential: a wide range of health care benefits for the long-term unemployed who do not meet the eligibility requirements for MassHealth Basic. Coverage is similar to MassHealth Basic, but more limited.

Useful links

Links to other web sites with information about MassHealth.

 

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