Last updated: September 6, 2025
Massachusetts Medicaid (MassHealth) income limits vary by program type and household size.
For 2025, non-MAGI seniors qualify with income under $1,305/month (single) or $1,773/month (couple), while Medicaid expansion adults can earn up to 138% FPL ($1,843/month for one person).
Children and pregnant individuals qualify up to 150-190% FPL. Long-term care has no strict income cap—you contribute most income to care costs while keeping a $72.80 Personal Needs Allowance.
Key Takeaways
✅ Massachusetts offers comprehensive Medicaid coverage through multiple programs
✅ Income limits range from $1,305/month (seniors) to $2,565/month (pregnant individuals)
✅ No asset limits for MAGI programs (under 65, not on Medicare)
✅ Long-term care accessible regardless of income through contribution system
✅ Spousal protections ensure community spouse financial security
✅ HCBS waivers provide home-based care alternatives to nursing facilitie
2025 MassHealth Income Standards (MAGI Programs)
MassHealth uses Modified Adjusted Gross Income (MAGI) rules for individuals under 65 who aren’t on Medicare, including children, pregnant people, parents, and expansion adults.
MAGI Income Limits by Household Size
| Household Size | 100% FPL | 133% FPL (Adults) | 150% FPL (Children) | 190% FPL (Pregnant) |
|---|---|---|---|---|
| 1 | $1,350/mo | $1,796/mo | $2,025/mo | $2,565/mo |
| 2 | $1,830/mo | $2,434/mo | $2,745/mo | $3,477/mo |
| 3 | $2,310/mo | $3,072/mo | $3,465/mo | $4,389/mo |
| 4 | $2,790/mo | $3,711/mo | $4,185/mo | $5,301/mo |
| 5 | $3,270/mo | $4,349/mo | $4,905/mo | $6,213/mo |
| 6 | $3,750/mo | $4,988/mo | $5,625/mo | $7,125/mo |
| 7 | $4,230/mo | $5,626/mo | $6,345/mo | $8,037/mo |
| 8 | $4,710/mo | $6,264/mo | $7,065/mo | $8,949/mo |
Each additional person adds $480 at 100% FPL. Figures effective March 1, 2025 – February 28, 2026.
Who Qualifies Under MAGI Rules?
- Medicaid Expansion Adults (19-64): Up to 133% FPL
- Children (0-18): Up to 150% FPL
- Pregnant Individuals: Up to 190% FPL
- Parents/Caretakers: Up to 133% FPL
Seniors & People with Disabilities (Non-MAGI) Limits
For applicants 65+ or receiving Medicare, different income and asset rules apply:
2025 Non-MAGI Income Limits
- Single applicant: $1,305/month
- Married couple: $1,773/month (combined income)
- Asset limits: $2,000 (individual) | $3,000 (couple)
Medicare Savings Programs
| Program | Single Income | Couple Income | What’s Covered |
|---|---|---|---|
| QMB | Up to $1,305/mo | Up to $1,773/mo | Medicare premiums, deductibles, copays |
| SLMB | $1,306-$1,566/mo | $1,774-$2,127/mo | Medicare Part B premiums only |
| QI | $1,567-$1,758/mo | $2,128-$2,389/mo | Medicare Part B premiums (limited funding) |
If income exceeds these limits, you may still qualify through MassHealth Spend-down.
Long-Term Care Medicaid in Massachusetts
MassHealth covers nursing home care and home-based services without strict income limits.
Income Contribution Rules
- No income limit: All income must go toward care costs, except:
- Personal Needs Allowance: $72.80/month (for resident)
- Community Spouse Allowance (MMMNA):
- Minimum: $2,465/month (September 2025)
- Maximum: $3,948/month (January 2025)
Asset Protection for Spouses
- Community spouse may retain up to $157,920 in assets
- Home equity protected up to $713,000 (2025 limit)
- One vehicle of any value is exempt
Home & Community-Based Services (HCBS) Waivers
HCBS waivers help Massachusetts residents receive care at home instead of nursing facilities.
2025 HCBS Waiver Limits
- Income cap: $2,901/month (300% of SSI Federal Benefit Rate)
- Asset cap: $2,000 (individual) | $157,920 (community spouse)
Available Waiver Programs
- Adult Foster Care (AFC)
- Adult Family Care (AFCP)
- Group Adult Foster Care (GAFC)
- Residential Support (RSS)
Each waiver has specific eligibility criteria beyond income and assets.
Asset Limits & MassHealth Spend-Down
Standard Asset Limits (2025)
| Program Type | Individual | Couple |
|---|---|---|
| MAGI Programs | No asset limit | No asset limit |
| Non-MAGI (Seniors/Disabled) | $2,000 | $3,000 |
| Long-Term Care | $2,000 | $157,920 (community spouse) |
MassHealth Spend-Down Program
If your income exceeds limits, you may qualify by “spending down” excess income on medical expenses:
- Calculate excess income above the limit
- Accumulate medical bills equal to 6 months of excess income
- Submit receipts to MassHealth for approval
- Receive coverage for remaining months in the period
Example: Income $200 over limit = $1,200 spend-down requirement (6 × $200)
How to Apply for MassHealth
Step-by-Step Application Process
- Pre-Application Check
- Use the MassHealth eligibility calculator
- Gather required documents (see checklist below)
- Submit Application
- Online: MassHealth Connector
- Phone: 1-800-841-2900 (TTY: 1-800-497-4648)
- Mail/In-Person: Local MassHealth Enrollment Centers
- Required Documents
- Photo ID (driver’s license, passport)
- Social Security cards for all applicants
- Proof of Massachusetts residency
- Income verification (pay stubs, tax returns, Social Security statements)
- Bank statements and asset documentation
- Immigration documents (if applicable)
- Application Review
- Processing time: 45 days for most applications
- Interview: May be required for certain cases
- Verification: Additional documents may be requested
- Coverage Begins
- Effective date: Usually the application date
- Retroactive coverage: Up to 3 months for medical bills
Application Tips for Approval
- Apply early: Don’t wait until you need immediate care
- Complete documentation: Missing papers delay approval
- Report changes: Income, address, or household size changes within 10 days
- Keep copies: Maintain records of all submitted documents
Frequently Asked Questions
What is the Medicaid income limit for a single person in Massachusetts in 2025?
For seniors (65+): $1,305/month. For expansion adults (19-64): $1,796/month (133% FPL). Income limits vary by age group and program type.
Does Massachusetts Medicaid have an asset limit?
Yes. Most programs limit assets to $2,000 for individuals and $3,000 for couples. MAGI programs (under 65, not on Medicare) have no asset limits.
How much income can a spouse keep if I’m in a nursing home?
In 2025, a community spouse may keep between $2,465–$3,948/month, depending on housing costs and other factors. This ensures financial stability for the at-home spouse.
Does MassHealth cover long-term care at home?
Yes, through HCBS waiver programs for applicants with income under $2,901/month and assets under $2,000. Services include personal care, adult day health, and respite care.
Do MassHealth income limits change every year?
Yes, limits update annually on March 1 based on federal poverty level adjustments. Some limits may also change mid-year due to federal policy updates.
Can I get MassHealth if I’m over the income limit?
Possibly. Options include the Spend-down program (paying excess income toward medical bills) or Medicare Savings Programs with higher income limits.
Conclusion
Ready to apply? Use the Massachusetts Medicaid eligibility calculator to confirm your qualification and start your application through the MassHealth Connector.
Important Notice: This information is current as of September 2025. MassHealth rules change periodically. Always verify current limits and requirements with Mass.gov or call MassHealth Customer Service at 1-800-841-2900 before making eligibility decisions.
Disclaimer: This guide provides general information only and should not be considered legal or financial advice. Consult with a qualified benefits counselor or attorney for personalized guidance on your specific situation.