How to get MassHealth or low-cost care in Massachusetts

MassHealth in plain words

Medicaid is a program that pays for health care for people with low incomes. In Massachusetts the program goes by the name MassHealth. It is part of the state's Executive Office of Health and Human Services. The state applied the Affordable Care Act's Medicaid expansion in 2014, so adults can qualify based on income alone.

The limit for most adults under 65 is 138 percent of the federal poverty level. That level is a yearly dollar amount the government uses to measure poverty. The exact figure depends on how many people live in your home. Children, older adults, people with disabilities and pregnant people each follow their own rules. Our guide on who qualifies for Medicaid explains each group.

How to apply for MassHealth

One application covers MassHealth, the Health Safety Net and the Children's Medical Security Plan. The state lists several ways to send it in, and the list below shows them.

• You can apply online after you make an MA Login account.
• You can call the MassHealth Customer Service Center at 800-841-2900 on weekdays from 8 in the morning to 5 in the afternoon. People who use a TTY line can dial 711.
• You can mail a paper application to the Health Insurance Processing Center, PO Box 4405, Taunton, MA 02780, or fax it to 857-323-8300.
• You can get help in person from an enrollment assister or at a MassHealth Enrollment Center, which gives limited walk-in help.

Enrollment Centers can help you fill out the form, but you should not mail or fax your application to them. The Health Connector says you can apply for MassHealth and the other programs at any time of the year. Before you start, look at our guide on how to apply for Medicaid, which lists the papers to gather.

What the Health Safety Net does

The Health Safety Net is a state fund that pays hospitals and community health centers. The money covers care given to Massachusetts residents who have limited incomes and do not have full coverage. A state report says residents with incomes up to 150 percent of the federal poverty level can qualify for full coverage. People between 150 and 300 percent can get partial coverage. That coverage comes with an income-based deductible, which is an amount you pay before the fund starts to help.

You do not need a separate form for this fund. The same state application covers it, so you can apply even if you are not sure which program fits you.

Is health insurance required in Massachusetts?

Yes, Massachusetts has had its own coverage rule for years, even though the federal penalty is $0. The state Department of Revenue says most adults 18 and older must have health insurance if they can afford it. The plan must meet the Health Connector's minimum standards. If you go without it, the penalty is added to your state income tax return. Our guide on whether it is illegal to go without insurance compares the states that have a penalty.

For tax year 2026, adults with income at or below 150 percent of the federal poverty level pay no penalty. Above that line, the penalty is a monthly amount that rises with income. It runs from $26 a month for the lowest tier above 150 percent to $211 a month for people above 400 percent. The penalty cannot be more than half of the lowest monthly premium you could have paid through the Health Connector.

The penalty has two more protections. A gap in coverage of 63 days or less brings no penalty. You can also appeal to the Health Connector if hardship kept you from buying coverage. Married couples owe the sum of each spouse's penalty. A tax adviser or the Department of Revenue can tell you what applies to your return.

Changes coming to MassHealth in 2027

The federal government is adding work or school rules, called community engagement rules, for some Medicaid members. MassHealth says some members will face the new rules or more frequent renewals starting in January 2027. The state also says the changes will not affect most members, and it will contact the people who are affected.

The federal agency that runs Medicaid says the work rule is 80 hours a month for adults ages 19 to 64. It has exceptions, such as parents of a child 13 or younger. MassHealth offers an online screener that tells you whether the changes could affect you. You should also keep your phone number and mailing address current. Tell the state about a new pregnancy, a disability or a change in income. Our Medicaid work requirement guide has more detail.

If your income is above the MassHealth limit

Massachusetts runs its own marketplace, called the Massachusetts Health Connector. A marketplace is a website where you compare private health plans, and a tax credit is government money that lowers your monthly payment. The Health Connector says open enrollment for 2027 coverage starts October 23. The help line for individuals is 877-623-6765, and it is open on weekdays from 8 in the morning to 6 in the evening.

The Health Connector also offers a program called ConnectorCare to help people pay for coverage. You can apply for it at any time of the year. The extra federal credits ended after 2025, and the old 400 percent of poverty cap returned in 2026. Look at the current numbers before you decide.

Health centers, doctor lookups and emergency care

Community health centers are clinics that get federal money and charge by income and family size. Health centers see everyone, with or without coverage. To find one, type your zip code into the free Find a Health Center tool from the Health Resources and Services Administration. The Massachusetts League of Community Health Centers represents them in the state. Ask each center about its sliding fee and how to become a new patient. Our guide to sliding-scale clinics can help you compare.

The state runs a site called FindMyDoctor.mass.gov, where you can check any physician licensed in Massachusetts. Full profiles can show medical school, training and accepted insurance plans. Profiles can also show Board discipline and malpractice payments reported to the Board.

Some Massachusetts doctors charge a flat monthly fee for primary care and do not bill insurance for it, which is called direct primary care. Our directory lists cash-pay doctors you can search. If you have chest pain, trouble breathing or another emergency, call 911 or go to the nearest emergency room. Federal law says the hospital must examine you and treat an emergency whether or not you can pay.