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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

(I) Eligibility Requirements for Department of Mental Health (DMH) Members. An individual who receives services from the DMH, or has been determined eligible for such services and is on a waiting list, is eligible for MassHealth Standard if the individual (1) is younger than 65 years old; (2) has modified adjusted gross income of the MassHealth MAGI household of less than or equal to 133% of the FPL; (3) is a citizen as described at CMR 504.002: U.S. Citizens or qualified noncitizen as described at 130 CMR 504.003(A)(1): Qualified Noncitizens; and (4) is not otherwise eligible for MassHealth Standard.

(J) Eligibility Requirements for Individuals Who Are Medically Frail. An individual who is medically frail is eligible for MassHealth Standard if the individual (1) is younger than 65 years old; (2) is medically frail as defined at 130 CMR 505.008(F); (3) has modified adjusted gross income of the MassHealth MAGI household of less than or equal to 133% of the FPL; (4) 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; and (5) has been determined to meet the eligibility criteria for MassHealth CarePlus and has elected to receive MassHealth Standard benefits.

(K) Eligibility Requirements for Certain Emergency Aid to the Elderly, Disabled and Children (EAEDC) Recipients. (1) Eligibility Requirements. Certain EAEDC recipients are eligible for MassHealth Standard. if (a) the individual is 1. a child and is a citizen as defined in 130 CMR 504.002: U.S. Citizens or a lawfully present immigrant as defined in 130 CMR 504.003(A): Lawfully Present Immigrants; 2. the individual is a young adult and is a citizen as defined in 130 CMR 504.002: U.S. Citizens or a lawfully present immigrant as defined in 130 CMR 504.003(A): Lawfully Present Immigrants; 3. the individual is a parent or caretaker relative and is a citizen as defined in 130 CMR 504.002: U.S. Citizens or a qualified noncitizen as defined in 130 CMR 504.003(A)(1): Qualified Noncitizens; 4. the individual is an adult 21 to 64 and is a citizen as defined in 130 CMR 504.002: U.S. Citizens or a qualified noncitizen as defined in 130 CMR 504.003(A)(1): Qualified Noncitizens; and (b) the individual receives EAEDC cash assistance. (2) Eligibility End Date. Individuals whose EAEDC cash assistance terminates and who are determined to be potentially eligible for MassHealth continue to receive medical benefits under MassHealth Standard until a determination of ineligibility is made by MassHealth.