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CommonHealth

What is CommonHealth?

Am I eligible?

What are the income and asset limits?

What benefits will I get?

How do I apply?

How much does it cost?

NOTE: Glossary words are highlighted. Click on any glossary word to see its definition.

What is CommonHealth?

CommonHealth is comprehensive health insurance similar to MassHealth Standard, for eligible disabled adults and disabled children through age 18 who cannot get MassHealth Standard because their incomes are too high.

Am I eligible?

To be eligible for CommonHealth, you must be disabled and a U.S. citizen or eligible noncitizen who is not eligible for MassHealth Standard (see Can noncitizens get MassHealth?)

This program is for:

  • children under age 19 with disabilities 
  • adults with disabilities who work 40 or more hours per month
  • adults with disabilities, under age 65, who are not working or are working less than 40 hours per month

For more information about MassHealth eligibility, see Am I Eligible?

You can use the MassHealth Eligibility Check to see if you are likely to qualify for MassHealth benefits.

What are the income and asset limits?

There are no income or asset limits for CommonHealth. However, if your income is greater than 150% of the Federal Poverty Guidelines, you may have to pay a monthly premium. Most non-working disabled adults with incomes above 133% FPG have to meet a one-time-only deductible to become eligible for CommonHealth. Special rules apply to disabled adults who are HIV positive.

See MassHealth income limits for dollar amounts.

What benefits will I get?

CommonHealth offers comprehensive health coverage. Benefits include:

  • inpatient and outpatient hospital services
  • doctor, nurse practitioner, nurse midwife, and clinic visits
  • well-child visits including immunizations
  • early intervention
  • pharmacy services
  • long-term care in a medical facility (nursing home, hospital, etc.)
  • mental health and substance abuse services
  • audiologist services and hearing aids
  • vision care including eyeglasses and magnifying aids
  • chiropractor services
  • podiatrist services and orthotics
  • prosthetic services
  • abortion and family planning services
  • rehabilitation and therapy services (physical, occupational, speech)
  • renal dialysis
  • smoking cessation services
  • home health care
  • personal care and private duty nurse services
  • hospice services
  • x-rays and laboratory work
  • medical equipment and supplies
  • oxygen and respiratory equipment
  • adult foster care, adult day health care, and day habilitation services
  • dental services for children and adults including checkups, cleanings, fillings, dentures, and other approved procedures
  • ambulance and transportation services

Your coverage may also include other benefits not listed above. Call the MassHealth Customer Service Center at 1-800-841-2900 (TTY: 1-800-497-4648) if you have any questions about your benefits.

Your coverage may begin 10 days before the date MassHealth received your application, if you get all necessary information to them within 60 days.

How do I apply?

You must file a MassHealth application, called the Medical Benefit Request (MBR). For application information, see How Do I Apply?

How much does it cost?

CommonHealth members with family incomes above 150% of the Federal Poverty Guidelines have to pay monthly premiums. The premiums are based on a sliding fee scale, depending on income and family size. Monthly premiums are waived for CommonHealth children whose parents pay monthly premiums for Commonwealth Care.

Non-working disabled adults with incomes above 133% FPG have to meet a one-time-only deductible to become eligible for CommonHealth. The deductible is met if the family's medical bills (not covered by insurance) over a six-month period are equal to or greater than the family's deductible amount. The deductible amount depends on family income, family size, and the CommonHealth Deductible Income Standard.

The deductible does not apply to non-working disabled HIV positive adults with incomes no greater than 200% FPG.

Detailed information about the deductible is in the MassHealth Financial Requirements regulations: 130 CMR 506.009.

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