Medicaid eligibility rules are changing

New federal work and education requirements for MassHealth members 

Some adults ages 19-64 enrolled in MassHealth (Medicaid) may need to meet specific work and education requirements to keep their coverage. If the new rules apply to you, you will need to complete at least 80 hours each month of approved activities such as work, education, job training, or community service, or a combination of these, unless you qualify for an exemption. 

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What you should do now

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See if you're impacted
Check if you may need to meet the new work and education requirements by using MassHealth's screening tool. The screening tool does not provide an official decision but if you’re impacted, you’ll receive a notice from MassHealth.

Use the screening tool

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Update your information
MassHealth will notify you through mail, email, text and more. Update your mobile number, mailing address and email address with MassHealth to ensure you don’t miss important notices.

Update your contact info

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Get more help
MassHealth has created a webpage to keep you informed about the federal changes affecting MassHealth members. Visit this page to learn how they may impact you or your family.

Visit MassHealth.org

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Qualifying activities

To keep your MassHealth coverage, you must meet one of the following requirements, or a combination of the activities below:

  • Work at least 80 hours per month
  • Complete at least 80 hours of community service per month
  • Participate in a work/job program for at least 80 hours per month
  • Be enrolled in an educational program at least half-time
  • Have a monthly income that is not less than the applicable federal minimum wage (approximately $580 per month)

Exemptions

You may be exempt from these requirements if you are:

  • 18 years or younger/65 years or older
  • Pregnant or less than 12 months postpartum
  • A parent, guardian or caretaker of a child who is younger than 14 or is a disabled individual 
  • Eligible for Medicare Part A or enrolled in Medicare Part B
  • Younger than 26 and had Medicaid when you aged out of foster care
  • Living with one of the following conditions: a disability that seriously limits your ability to do a daily task (such as bathing, dressing, eating) without help; an alcohol or drug addiction; a serious mental health condition (such as schizophrenia or major depression); a serious or complex condition (such as cancer or heart failure) that requires frequent medical care; blindness or disability based on Social Security rule 
  • Receiving Transitional Aid to Families with Dependent Children (TAFDC) cash help and are meeting TAFDC work rules
  • Served in the U.S. Armed Forces and have a total disability rating from the Department of Veterans Affairs (VA)
  • A member of a household that gets Supplemental Nutrition Assistance Program (SNAP) benefits and DTA told you that you must meet work rules
  • Participating in certain substance use disorder treatment and rehabilitation programs
  • An inmate of a public institution, or you were an inmate in the previous three months
  • Certain American Indians or Alaska Natives 

Exceptions

The work and community engagement requirements will not apply to members in the following groups:

  • Caregivers of children ages 13 and under or disabled individuals
  • Medically frail individuals
  • Members who are pregnant or postpartum
  • Former foster youth under age 26
  • American Indians / Alaska Natives

  • Individuals meeting TANF or SNP requirements
  • Veterans with total disability
  • Individuals in qualifying substance use disorder rehab or treatment programs
  • Recently incarcerated individuals (within 3 months)
  • Members of Medicare A/B