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9 130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 255 Rev. 02/13/26

130 CMR 515.000: MASSHEALTH: GENERAL POLICIES

Premium Tax Credit. Payment made pursuant to 26 U.S.C. § 36B on behalf of an eligible individual to reduce the costs of a health benefit plan premium to the individual.

Promissory Note. A written promise to pay another.

Protected Noncitizens. See 130 CMR 518.003(B): Protected Noncitizens.

Qualified Health Plan (QHP). A health plan licensed under M.G.L. Chapter 175, 176A, 176B, or 176G that has received the Commonwealth Health Insurance Connector’s Seal of Approval as meeting the criteria under 45 CFR § 155.1000 and is offered through the Health Connector in accordance with the provisions of 45 CFR § 155.1010.

Qualified Noncitizens. See 130 CMR 518.003(A)(1): Qualified Noncitizens.

Qualified Noncitizens Barred. See 130 CMR 518.003(A)(2): Qualified Noncitizens Barred.

Quality Control. A system of continuing review to measure the accuracy of eligibility decisions.

Reapplication. The MassHealth agency’s reopening of the application process when the application has been denied pursuant to 130 CMR 516.001(C): Receipt of Corroborative Information.

Redetermination. A review of a member’s circumstances to establish whether they remain eligible for benefits.

Resources. All income and assets owned by the individual or their spouse. For the purposes of determining eligibility, resources include income and assets to which the individual or spouse is, or would be, entitled whether or not they are actually received. This term has the same meaning as assets as defined in 42 U.S.C. § 1396p(e)(1).

Reverse Mortgage. A loan on the equity value of a house paid in installments by a lender to the homeowner who is 60 years of age or older.

Revocable Trust. A trust whose terms allow the grantor to take action to regain any of the property or funds in the trust.

Senior Application or Application. The request for health benefits for an individual who is 65 years of age and older, or not living in the community, that is received by the MassHealth agency and includes all required information and a signature by the applicant or their authorized representative.

Senior Care Organization. An organization that participates in MassHealth under a contract with the MassHealth agency and Centers for Medicare & Medicaid Services to provide a comprehensive network of medical, healthcare, and social-service providers that integrates all components of care, either directly or through subcontracts. Senior care organizations are responsible for providing enrollees with the full continuum of Medicare- and MassHealth-covered services.