Update to MassHealth CommonHealth Eligibility for Seniors

The Center for Medicare and Medicaid Services (CMS) recently approved MassHealth’s 1115 waiver which expands eligibility for CommonHealth applicants who are age 65 and older. Members who were enrolled on MassHealth CommonHealth for at least 10 years are now eligible to remain on MassHealth CommonHealth after turning 65. This CommonHealth expansion will allow seniors determined to have a disability at higher income levels who are not working and may not otherwise have been eligible to remain on MassHealth. Prior to the implementation of this rule, members who were eligible for MassHealth CommonHealth and turned 65 were either no longer eligible for CommonHealth or had to continue to be employed at least 40 hours per month. MassHealth members who do not meet the 10-year criteria may still receive CommonHealth if they continue to be employed at least 40 hours per month (or have worked at least 240 hours in the six months before the date of the SACA-2-ERV submission). Members applying for MassHealth CommonHealth aged 65 and older, regardless of employment status, will be subject to all other rules for the CommonHealth program, including payment of premium bills.

These members will be required to submit an updated renewal or SACA-2 application for seniors over age 65, and MassHealth must confirm that they do not otherwise meet the criteria for MassHealth Standard. When a CommonHealth member age 65 and older submits an application or renewal to apply for the expansion, they should write “CommonHealth” on the front page of the application so the renewal form is routed to the appropriate unit for processing.

Please see MassHealth’s Eligibility Operations Memo 23-19: Changes to MassHealth CommonHealth Eligibility for Seniors for the official announcement of this change.