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130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 251 Rev. 02/13/2026

130 CMR 501.000: HEALTH CARE REFORM: MASSHEALTH: GENERAL POLICIES

individuals enrolled in health plans.

Continuous Eligibility (CE). Certain groups of people may receive a period of continuous coverage upon initial eligibility determination or after a successful eligibility renewal. (1) Applicable coverage types, groups of members who are eligible for CE periods, and timeframes of continuous coverage are found in 130 CMR 505.002, 130 CMR 505.004, 130 CMR 505.005, and 130 CMR 505.008. (2) A CE period lasts from initial determination or renewal until the person is picked up for their next renewal. If MassHealth determines the person remains eligible for MassHealth, another period of continuous eligibility may be granted. If the person does not respond to their renewal within the given timeframe, or is found to be ineligible for MassHealth, MassHealth will not grant the person another CE period. (3) MassHealth may upgrade a person who is in a CE period to a richer coverage type during the CE period. MassHealth will not downgrade, except in cases where a change in immigration status requires a downgrade under federal law, or terminate coverage during a person’s CE period until their CE period is over, unless one of the exceptions below applies. MassHealth may end a person’s CE period outside of the completed renewal period for the following reasons: (a) voluntary withdrawal; (b) person moved out of state; (c) a child attains age 19; (d) death of eligible member; or (e) the agency determines that eligibility was erroneously granted at the most recent determination, redetermination or renewal of eligibility because of agency error or fraud, abuse, or perjury attributed to the individual.

Couple. Two persons who are married to each other according to the laws of the Commonwealth of Massachusetts.

Coverage Start Date (or Start Date of Coverage). The date medical coverage begins.

Coverage Type. A scope of medical services, other benefits, or both that is available to members who meet specific eligibility criteria. MassHealth coverage types include the following: MassHealth Standard (Standard), MassHealth CommonHealth (CommonHealth), MassHealth CarePlus (CarePlus), MassHealth Family Assistance (Family Assistance), and MassHealth Limited (Limited). The scope of services or covered benefits for each coverage type is found at 130 CMR 450.105: Coverage Types.

Custodial Parent. (1) the parent with whom a child's physical custody has been established by a court order or binding separation, divorce, or custody agreement; or (2) if no such order or agreement exists, the parent with whom the child spends most nights;