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22 130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 258 Rev. 02/13/26

130 CMR 519.000: MASSHEALTH: COVERAGE TYPES

(a) they are employed at least 40 hours per month or, if employed less than 40 hours per month, have been employed at least 240 hours in the six-month period immediately before the month of receipt of the application or MassHealth’s eligibility review; (b) if they are not employed, they must have had CommonHealth for at least ten years before stopping working or turning 65 years old; (c) they are permanently and totally disabled (except for engagement in substantial gainful activity) as defined in 130 CMR 515.001: Definition of Terms; (d) they are a citizen as described in 130 CMR 518.002: U.S. Citizens or a qualified noncitizen as described in 130 CMR 518.003(A)(1): Qualified Noncitizens; and (e) they are ineligible for MassHealth Standard. (2) Other Provisions. The provisions of the following regulations apply to CommonHealth applicants and members 65 years of age or older: 130 CMR 505.004(A)(2), (H) through (J), (M)(1) and (2), and (N).

(B) Certain Disabled Institutionalized Children Who Are Noncitizens (1) Eligibility Requirements. MassHealth CommonHealth is available to institutionalized disabled children who meet the requirements of 130 CMR 505.004(G): Disabled Children Younger than 18 Years Old and 130 CMR 519.006(A)(2) and who (a) have attained the immigration status described in 130 CMR 518.003(A)(2): Qualified Noncitizens Barred, and five years have not passed from the date they attained such status; (b) are noncitizens under the Immigration and Nationality Act (INA); or (c) are noncitizens paroled into the US under the INA § 212(d)(5) for less than one year. (2) Other Provisions. The following provisions apply to CommonHealth applicants and members who are described in 130 CMR 519.012(B)(1): 130 CMR 505.004(A)(2), (H) and (J), and (M)(1) and (2).

(C) Financial Eligibility. Financial eligibility for all MassHealth CommonHealth applicants and members is based on 130 CMR 506.000: Health Care Reform: MassHealth: Financial Requirements. 130 CMR 520.000: MassHealth: Financial Eligibility does not apply.

(D) Medicare Premium Payment (1) MassHealth also pays the cost of the monthly Medicare Part B premium through the Qualifying Individual Program under 130 CMR 519.011(B) on behalf of members who meet the requirements of 130 CMR 505.004: MassHealth CommonHealth and who have modified adjusted gross income of the MassHealth disabled adult household that is less than or equal to 135% of the federal poverty level. (2) The coverage described in 130 CMR 505.004(L)(1) begins on the first day of the month following the date of the MassHealth eligibility determination and may be retroactive up to the first day of the third calendar month before the month of application.