The Massachusetts Medicaid income limit depends on who is applying. For most adults under 65, MassHealth sets the ceiling at 133% of the Federal Poverty Level, and a built-in 5% income disregard effectively lifts that to about 138% of FPL. Using the 2026 federal poverty guidelines, that works out to roughly $1,835 per month for a single person. Seniors 65 and older and people with qualifying disabilities face a stricter 100% FPL cap and must also pass an asset test. Pregnant people and children qualify at considerably higher income thresholds.
Income Limits for Adults Under 65
If you are under 65 and do not have a qualifying disability, MassHealth uses Modified Adjusted Gross Income rules to measure your household income against a percentage of FPL. MassHealth Standard, the most comprehensive tier, generally requires household income at or below 133% of FPL for parents, caretaker relatives, pregnant individuals, and children.1Legal Information Institute. Massachusetts Code 130 CMR 505.002 – MassHealth Standard MassHealth CarePlus covers other adults aged 21 through 64 — those who are not pregnant, disabled, or caring for dependent children — at the same 133% of FPL threshold.2Legal Information Institute. Massachusetts Code 130 CMR 505.008 – MassHealth CarePlus
Based on the 2026 federal poverty guidelines, the 133% FPL monthly income limits are approximately:3U.S. Department of Health and Human Services. 2026 Poverty Guidelines
- Single individual: $1,769 per month
- Household of two: $2,398 per month
- Household of three: $3,027 per month
- Household of four: $3,658 per month
The ceiling rises with each additional person in the household. MassHealth updates its income charts each March, after the federal government publishes new poverty guidelines.4Mass.gov. 2025 MassHealth Income Standards and Federal Poverty Guidelines Because MAGI uses gross income before taxes, pre-tax contributions to a retirement plan or health savings account can lower the number MassHealth sees.
The 5% Income Disregard
Federal law builds in a 5% FPL disregard for all MAGI-based Medicaid eligibility. If your income slightly exceeds 133% of FPL, you may still qualify as long as it stays within an additional five percentage points, effectively raising the ceiling to about 138% of FPL.5Medicaid.gov. MAGI Conversion and the 5% Disregard For a single person in 2026, that pushes the practical monthly limit to roughly $1,835. MassHealth applies the disregard automatically; you do not need to calculate it or request it.
Income That Does Not Count
Not every dollar you receive counts toward MAGI. Federal rules exclude scholarships and fellowship grants used for educational expenses (not living costs), and treat lump-sum payments as income only in the month received rather than spreading them across later months.6eCFR. 42 CFR 435.603 – Application of Modified Adjusted Gross Income Several categories of income specific to American Indian and Alaska Native individuals, including distributions from Alaska Native Corporations and payments from trust lands, are also excluded.
Income and Asset Limits for Seniors and People With Disabilities
If you are 65 or older, or living with a qualifying disability, MassHealth uses a different set of financial rules under 130 CMR 520.000 rather than MAGI.7Mass.gov. 130 CMR 520.000 – MassHealth Financial Eligibility The income limit for MassHealth Standard in this group is 100% of the Federal Poverty Level. Using the 2026 poverty guidelines, that comes to approximately:3U.S. Department of Health and Human Services. 2026 Poverty Guidelines
- Single individual: $1,330 per month ($15,960 per year)
- Couple: $1,803 per month ($21,640 per year)
Seniors and people with disabilities also face an asset test. For 2026, countable assets cannot exceed $2,000 for an individual or $3,000 for a married couple. Savings accounts, stocks, bonds, and secondary properties count. Your primary home is generally exempt as long as its equity stays within the 2026 limit of $1,130,000.8Mass.gov. Program Financial Guidelines for Certain MassHealth Applicants and Members
Higher Income Limits for Pregnant People and Children
Pregnant individuals can qualify for MassHealth Standard with household income up to 200% of the Federal Poverty Level.1Legal Information Institute. Massachusetts Code 130 CMR 505.002 – MassHealth Standard Under the 2026 guidelines, that is roughly $2,660 per month for a single person and $5,500 per month for a household of four.3U.S. Department of Health and Human Services. 2026 Poverty Guidelines Coverage includes prenatal care, delivery, and postpartum services. A child born to a parent receiving MassHealth Standard is automatically eligible for the first year of life.
Children benefit from an even higher ceiling through MassHealth Family Assistance, which covers children and young adults in households earning above the Standard threshold but at or below 300% of FPL, roughly $8,250 per month for a family of four in 2026.9Legal Information Institute. Massachusetts Code 130 CMR 505.005 – MassHealth Family Assistance If a family’s income exceeds that, the Children’s Medical Security Plan provides primary and preventive medical and dental coverage to uninsured children under 19 at any income level, as long as the child does not qualify for another MassHealth coverage type.10Mass.gov. Children’s Medical Security Plan
CommonHealth for People With Disabilities Over the Income Limit
If you have a qualifying disability but earn too much for MassHealth Standard, MassHealth CommonHealth may still cover you. To qualify, you must have been declared disabled by the Social Security Administration, the Massachusetts Commission for the Blind, or MassHealth itself through a disability supplement, and your household income must exceed the Standard limits (above 133% of FPL for people under 65, or above 100% of FPL for those 65 and older).11Mass.gov. MassHealth CommonHealth
CommonHealth has no upper income limit. You may need to pay a monthly premium based on your household’s finances, and if you miss the premium for 60 or more days, coverage is cancelled.12Mass.gov. MassHealth CommonHealth Frequently Asked Questions One meaningful advantage: medical assistance received through CommonHealth is exempt from estate recovery after death, which matters for people who own a home or other property.
The Spend-Down When Your Income Is Too High
If your income exceeds the MassHealth limit, you may still qualify through a “deductible,” commonly called a spend-down. It works like a health insurance deductible: you must incur medical expenses equal to the difference between your countable income and the MassHealth income standard over a six-month period.7Mass.gov. 130 CMR 520.000 – MassHealth Financial Eligibility Qualifying expenses include doctor and hospital bills, prescription costs, and health insurance premiums you pay out of pocket. Costs already covered by Medicare or other insurance do not count.
The six-month deductible period starts on the first day of the month you apply. It can begin up to three months earlier if you had covered medical expenses and were otherwise eligible during that time.7Mass.gov. 130 CMR 520.000 – MassHealth Financial Eligibility Once you submit medical bills totaling at least the deductible amount and MassHealth verifies them, coverage begins for the remainder of the six-month window. You remain responsible for the bills you used to meet the deductible; MassHealth covers additional expenses incurred during the rest of the period.
Long-Term Care: Spousal Protections and the Five-Year Look-Back
Two rules apply only when you are applying for MassHealth long-term-care coverage, such as nursing facility services, and they can change the asset picture significantly.
When one spouse needs nursing facility care or home-and-community-based services and the other continues to live at home, federal rules keep the at-home spouse from being left destitute. The community spouse is allowed to keep a protected share of the couple’s combined assets. For 2026, the federal minimum community spouse resource allowance is $32,532 and the maximum is $162,660.13Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards Assets above that maximum generally must be spent down before the spouse in care can qualify for MassHealth long-term-care coverage. The community spouse may also keep a monthly income allowance to cover living expenses.
Massachusetts also reviews your financial transactions for the 60 months (five years) before the date of a long-term-care application.14Mass.gov. Eligibility Letter 174 – Revisions to Look-Back Periods The goal is to identify assets you transferred for less than fair market value, such as a large cash gift to a relative or a sale well below market price. If MassHealth finds disqualifying transfers, it imposes a penalty period during which you are ineligible for long-term-care benefits. The length depends on the total value of the transferred assets divided by the average monthly cost of nursing home care in your area. If you gave away $100,000 and average monthly nursing home cost is roughly $14,000, the penalty runs about seven months. Recovering the transferred assets, for example by having a gift returned, can reduce or eliminate the penalty.