Your family must have limited income, or large medical bills that you cannot pay.
- Patients with limited incomes can qualify as Low Income Patients.
- Patients with large medical bills can qualify under Medical Hardship.
You must have no health insurance, or health insurance that does not pay for all medically necessary services.
You must be a resident of Massachusetts. Non-residents, including out-of-state college students, are not eligible.
Your citizenship or immigration status does not affect your eligibility.

Who is eligible for HSN Primary / HSN Secondary?

Massachusetts residents who meet the Health Safety Net income requirements may be eligible for HSN Primary or HSN Secondary:

HSN Primary: Eligible residents without health insurance can get Health Safety Net Primary. HSN Primary pays for all medically necessary services on the list of MassHealth Standard covered services as long as services are provided at Massachusetts community health centers or hospitals.

HSN Secondary: Eligible residents with limited health insurance can get Health Safety Net Secondary to pay for HSN services not covered by their primary insurance. To be covered, services must be provided at Massachusetts community health centers or hospitals. People eligible for HSN Secondary include:

residents with MassHealth Limited, MassHealth Prenatal, Family Assistance Premium Assistance, EAEDC, or Healthy Start (automatically eligible for Health Safety Net Secondary)
CenterCare members, Low Income Patients with private insurance, resident college students with SHIP, and children with CMSP coverage who meet the HSN income limits
residents with Medicare who meet the HSN income limits
Commonwealth Care members are eligible for Health Safety Net Secondary for dental services not included in their Commonwealth Care plan.
Commonwealth Care Bridge members are eligible for Health Safety Net Secondary for dental and vision services.

Who is not eligible for the Health Safety Net?

You are not eligible for Safety Net Low Income Patient benefits:

if you are enrolled in MassHealth Standard, CommonHealth, MassHealth Essential, MassHealth Basic, or Family Assistance Direct Coverage. (You can get temporary coverage in some cases.)
if you are eligible for MassHealth or Commonwealth Care, but did not enroll.
if you have access to affordable health insurance but you did not buy it.

The Commonwealth Connector has an online Affordability Tool and Schedule to let you see how much the state expects you to pay for health insurance, based on your income and family size.
if you lost your MassHealth or Commonwealth Care insurance because you did not pay your premiums.

What are the income limits for Low Income Patients?

The Health Safety Net (HSN) has three categories for Low Income Patients:

Health Safety Net - Primary is for uninsured patients with family income from 0% to 200% (inclusive) of the Federal Poverty Guidelines (FPG).
Health Safety Net - Secondary is for patients who have primary health insurance and with family income from 0% to 200% (inclusive) of the Federal Poverty Guidelines.
Health Safety Net - Partial is for patients with family income from 201% to 400% (inclusive) of the Federal Poverty Guidelines.

For annual income dollar amounts, see the Income Eligibility Table below.

What income is counted?

The Health Safety Net uses the same family size and countable income rules as MassHealth.

A family includes:

members of an immediate family who live together, including children under 19, any of their children, and their parents (natural, step, or adoptive) who live with them
an unborn child, if a member of the family is pregnant
children who are away at school
If children are being cared for by a relative instead of their parents, the caretaker relative can decide to be part of the family or not.

Note: For other rules about family size, contact MassHealth.

A family's countable gross annual income includes:

all earned income before taxes or employer deductions
(such as wages, tips, or self-employment income)
most unearned income before taxes
(such as Social Security, unemployment, child support/alimony, interest on bank accounts, and rental income minus expenses)

Income received by a TAFDC, EAEDC, or SSI recipient, and non-cash payments such as food stamps, are not counted. There are special income rules for people who are institutionalized, or are age 65 or older.

What are the asset limits?

There are no asset limits for the Health Safety Net Fund.

How do I qualify for Medical Hardship?

There are no income limits for Medical Hardship. Massachusetts residents at all income levels are eligible. You qualify for Medical Hardship if your family's allowed medical bills are higher than a specified percentage of your family's income.

For example, if your family income is less than or equal to 200% of the Federal Poverty Guidelines, you can qualify for Medical Hardship if your family's medical bills are greater than 10% of your income. In this case, the Health Safety Net (HSN) will pay HSN-eligible medical bills greater than 10% of your income.

The Medical Hardship income levels and percentages are listed in the table below:

**Medical Hardship Income Levels and Percentages**
Percentages of Federal Poverty Guidelines (FPG)
Income Level	Percentage of Gross Income
0% - 200% FPG	10%
201% - 300% FPG	15%
301% - 400% FPG	20%
401% - 600% FPG	30%
601% + FPG	40%

For dollar amounts, see the Income Eligibility Table.

Allowed medical expenses:

The medical bills must be for medical expenses allowed as deductions on federal income taxes.
The medical bills can be from any health care provider.
You must be responsible for paying the bills.
Medical Hardship will allow medical bills incurred up to 12 months prior to your application.

Note: While the Health Safety Net counts allowed medical bills from any health provider when determining eligibility for Medical Hardship, it will only pay for services covered by the Health Safety Net. The Health Safety Net will only pay for medically necessary services that are on the the list of MassHealth Standard covered services and are provided at Massachusetts community health centers or hospitals.

Income Eligibility Table

Income eligibility levels for Low Income Patients and Medical Hardship are shown in the table below:

Health Safety Net Income Eligibility Levels
(Gross Annual Income)
Percentages of 2009 Federal Poverty Guidelines (FPG)
Effective March 1, 2009 through February 28, 2010
Family size	100% FPG	200% FPG	300% FPG	400% FPG	600% FPG
1	$10,836	$21,672	$32,508	$43,344	$65,016
2	$14,580	$29,160	$43,740	$58,320	$87,480
3	$18,312	$36,624	$54,936	$73,248	$109,872
4	$22,056	$44,112	$66,168	$88,224	$132,336
5	$25,800	$51,600	$77,400	$103,200	$154,800
6	$29,532	$59,064	$88,596	$118,128	$177,192
7	$33,276	$66,552	$99,828	$133,104	$199,656
8	$37,020	$74,040	$111,060	$148,080	$222,120
each extra child add	+ $3,744	+ $7,488	+ $11,232	+ $14,976	+ $22,464

Families with incomes from 0% to 200% (inclusive) of the Federal Poverty Guidelines can get Health Safety Net Primary/Secondary benefits.
Families with incomes from 201% to 400% (inclusive) of the FPG can get Health Safety Net Partial benefits.
Families at any income level can get Medical Hardship benefits if their medical bills are very high compared to their income. See How do I qualify for Medical Hardship?

Can noncitizens get help from the Health Safety Net?

You can get help from the Health Safety Net if you are not a citizen. Your immigration status does not matter for this program. Undocumented noncitizens who meet the eligibility requirements can get Health Safety Net funds. You do not need a Social Security number.

Do I have to be a resident of Massachusetts?

You must be a resident of Massachusetts to qualify for the Health Safety Net. You do not have to live in Massachusetts for any specific length of time to become a resident. However, you must live here now and plan to continue living here. You can be homeless and still be considered a resident, even if you don't have an address.