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130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 254 Rev. February 13, 2026

130 CMR 505.000: HEALTH CARE REFORM: MASSHEALTH: COVERAGE TYPES

(f) the individual does not otherwise meet the requirements for MassHealth Standard described at 130 CMR 505.002(B) through (E). (2) Premiums. Individuals who meet the requirements of 130 CMR 505.002(F) are assessed a monthly premium in accordance with 130 CMR 506.011: MassHealth and the Children’s Medical Security Plan (CMSP) Premiums. (3) Duration of Eligibility. Individuals meeting the requirements of 130 CMR 505.002(F) are eligible for MassHealth Standard for the duration of their cancer treatment.

(G) Eligibility Requirements for Individuals Who Are HIV Positive. An individual who is HIV positive is eligible for MassHealth Standard coverage if (1) the individual is younger than 65 years old; (2) the individual has verified their HIV positive status by providing a letter from doctor, qualifying health clinic, laboratory, or AIDS service provider or organization. The letter must indicate the individual’s name and their HIV-positive status; (3) the modified adjusted gross income of the MassHealth MAGI household is less than or equal to 133% of the FPL; (4) the individual is a citizen as described in 130 CMR 504.002: U.S. Citizens or a qualified noncitizen as described in 130 CMR 504.003(A)(1): Qualified Noncitizens; and (5) the individual does not meet the requirements for MassHealth Standard described at 130 CMR 505.002(B) through (E).

(H) Eligibility Requirements for Former Foster-care Individuals. (1) An individual who was in foster care under the responsibility of a state or tribe and enrolled in Medicaid coverage on their 18th birthday, or later date of aging out, receives MassHealth Standard coverage until (a) their 26th birthday if the individual is a citizen, as described at 130 CMR 504.002: U.S. Citizens, or qualified noncitizen, as described at 130 CMR 504.003(A)(1): Qualified Noncitizens; or (b) their 21st birthday if the individual is a qualified noncitizen barred, as described at 130 CMR 504.003(A)(2): Qualified Noncitizens Barred, or a nonqualified individual lawfully present, as described at 130 CMR 504.003(A)(3): Nonqualified Individuals Lawfully Present. (2) An individual who was in foster care under the responsibility of a state or tribe on their 18th birthday and not enrolled in Medicaid coverage receives MassHealth Standard coverage until their 21st birthday if the individual is a citizen, as described at 130 CMR 504.002: U.S.US Citizens, a qualified noncitizen as described at 130 CMR 504.003(A)(1): Qualified Noncitizens, a qualified noncitizen barred, as described at 130 CMR 504.003(A)(2): Qualified Noncitizens Barred, or a nonqualified individual lawfully present, as described at 130 CMR 504.003(A)(3): Nonqualified Individuals Lawfully Present.