Q&A: Can turning 65 impact MassHealth eligibility?

Corinne Lofchie is an Elder Care Advisor and SHINE Counselor at Somerville-Cambridge Elder Services

A: Yes, the eligibility rules for MassHealth change in a couple of important ways when people turn 65, particularly for MassHealth Standard, which provides the most comprehensive coverage.

There are also other types of MassHealth for people 65 and older, which have different eligibility criteria than Standard, some of which will be discussed in this post. These types include CommonHealth, Senior Buy-In and Buy-In.  

For MassHealth Standard the income limit goes down when you turn 65. There are some people who have had MassHealth Standard their whole life due to a disability, and then they turn 65 and they are no longer eligible for it, because their income is a little too high.  

The other big change is that when you are under 65 there is no asset limit. MassHealth does not look at your savings– you can have a large bank account or trust or things like that. But once you turn 65, they look at your assets. For MassHealth Standard you can only have up to $2,000 in savings, although there are certain types of assets that are not counted towards this limit. That number has not changed in a long time, and there have been efforts to increase it, but it hasn’t gone anywhere yet. 

For people with a disability who are no longer eligible for MassHealth Standard after they turn 65, MassHealth CommonHealth may be an option as there is no income or asset limit, although there is a requirement that the person work in some way for at least 40 hours a month. CommonHealth provides much of the same coverage as Standard, with some exceptions, the primary one being that it does not cover long-term care. 

Another option is the MassHealth Senior Buy-In, which acts similar to a Medicare supplement plan, covering deductibles and co-insurance of Medicare covered services, as well as the Medicare premium. It has a slightly higher income limit than MassHealth Standard and a substantially higher asset limit. The MassHealth Buy-In is also a possibility for those who are not eligible for either CommonHealth or Senior Buy-In, as it has a higher income limit than the Senior Buy-In. The benefit of the MassHealth Buy-In is that MassHealth will pay the Medicare Part B premium.  

It can be very helpful to call the Aging Information Center before turning 65, as there may be some simple steps that can allow you to maintain MassHealth coverage. Depending on the types of assets a person has, we may also refer them to an elder law attorney for further guidance. If someone has already lost their MassHealth after turning 65, we may also be able to help them to get back onto MassHealth, depending on their situation. 

Corrine Lofchie is an Elder Care Advisor at Somerville-Cambridge Elder Services (SCES), a non-profit dedicated to supporting the independence and well-being of older adults and adults with disabilities in Cambridge and Somerville. For free advise and guidance on questions of aging, caregiving, or disability, contact the SCES Aging Information Center at  617-628-2601 or email info@eldercare.org.