KB Category MassHealth

Federal Poverty Level (FPL)

The Federal Poverty Level, or FPL, is a measure of income level published each year by the Department of Health and Human Services. Federal poverty levels are used to help determine your eligibility for certain programs and benefits.The 2024 Income Standards and Federal Poverty Levels are used to determine who may be currently eligible for MassHealth programs for 2024.The 2023 Federal Poverty Levels are used to determine who may be eligible for Health Connector or ConnectorCare plans during the 2024 plan year, January 1 through December 31, 2024. 2024 MassHealth Income Standards and Federal Poverty Guidelines Family Size MassHealthIncome Standards 100%Federal Poverty Level 133%Federal Poverty Level 150%Federal Poverty Level 190% Federal Poverty Level Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly 1 $522 $6,264 $1,255 $15,060 $1,670 $20,040 $1,883 $22,596 $2,385 $28,620 2 $650 $7,800 $1,704 $20,448 $2,266 $27,192 $2,555 $30,660 $3,237 $38,844 3 $775 $9,300 $2,152 $25,824 $2,862 $34,344 $3,228 $38,736 4 $891 $10,692 $2,600 $31,200 $3,458 $41,496 $3,900 $46,800 5 $1,016 $12,192 $3,049 $36,588 $4,055 $48,660 $4,573 $54,876 6 $1,141 $13,692 $3,497 $41,964 $4,651 $55,812 $5,245 $62,940 7 $1,266 $15,192 $3,945 $47,340 $5,247 $62,964 $5,918 $71,016 8 $1,383 $16,596 $4,394 $52,728 $5,844 $70,128 $6,590 $79,080 For each additional person add $133 $1,596 $449 $5,388 $597 $7,164 $673 $8,076 These figures are rounded and may not reflect the figures used in program determination. Institutional Income Standard is $72.80. Family Size 200%Federal Poverty Level 225%Federal Poverty Level 250%Federal Poverty Level [...]

What’s the difference between the Health Connector and MassHealth?

We’ve heard questions from many members over the years who are confused about the difference between MassHealth and the Health Connector. Here’s a quick overview of the differences between these two separate state agencies: Massachusetts Health ConnectorWhere people who don’t get coverage through a job can buy a health or dental plan Where people with any level of income can buy a health plan The only place where people can get access to special programs to save money on health insurance if they qualify MassHealthWhere people can get free and low-cost health coverage if they qualify based on income level, a disability, pregnancy, or chronic (long-term) illness How are the agencies connected?One application for coverageWhen people apply for coverage at MAhealthconnector.org, they fill out one application to find out if they qualify for coverage through MassHealth, the Health Connector, or both. People or families can have a mix of coverage from both agenciesFor example, a family could have parents covered by the Health Connector with children who are covered by MassHealth. Or a person may get temporary benefits from MassHealth (called Health Safety Net) that cover some services before their Health Connector enrollment starts.Who do I call for help?If you need help with MassHealth benefits, call the MassHealth contact center at 1-800-841-2900, or TTY 1-800-497-4648. This is a separate call center from the Health Connector.If you need help with Health Connector coverage, call the Health Connector at 1-877-MA-ENROLL (1-877-623-6765), or TTY 711.

What is the best way to apply for coverage?

The fastest way to apply is through the online application. If you would like help applying for insurance, you can get free help with an Enrollment Assister organization in your area. Find a location near you →You may also apply by phone by calling customer service at 1-877 MA ENROLL (1-877-623-6765) or TTY: 711.You can also apply through a paper application. Download a copy of the paper application from the Forms page or call 1-877 MA ENROLL (1-877-623-6765) or TTY: 711 to have a paper copy mailed to you.

Do I have to buy through the Health Connector if I want to get help paying for insurance?

Yes, help paying for insurance through tax credits and low-cost ConnectorCare plans is only available through the Health Connector. Even if you enroll in a plan without help paying for it through the Health Connector, if you end up qualifying for a tax credit based on your income for that year, the IRS will let you to claim the tax credit when you file your taxes at the end of the year. But the tax credit is not available for someone who buys a plan outside of the Health Connector. You can also apply through the Health Connector website to see if you qualify for MassHealth coverage.

How is income now measured for determining who can get help paying for insurance?

Eligibility for help paying for insurance is no longer determined by your gross (total) income. Under national health reform, Modified Adjusted Gross Income (MAGI) is now used instead. Under MAGI you can factor in business expenses that you write off for tax purposes (your Schedule C losses) when calculating your income. This means that many more people may qualify for help who might not have been able to get it in the past. Most people can look at their adjusted gross income (line 8b on their Form 1040 income tax return) to see what their MAGI number will most likely be. This is an important change to understand for those who are self-employed or have combination income sources that include self-employment income.

When can I apply for coverage?

In general, an open enrollment period is the time of year when people applying for health insurance can enroll or change a plan for any reason. The next Open Enrollment for Massachusetts begins November 1, 2024. If you qualify for help paying for coverage through programs like MassHealth or a ConnectorCare plan, or experience a qualifying life event, you may enroll at any time during the year. If you do not qualify for help paying for coverage, there are certain qualifying events that allow you to enroll in coverage at other times during the year. Qualifying events include (but are not limited to): adding a dependent through birth or marriage, moving to a new permanent address in Massachusetts, becoming a citizen, national, or lawfully present individual, or getting a waiver from the Office of Patient Protection. For more information on qualifying events, go to our Closed Enrollment information page.

Where do I find out if I qualify for help to pay for my health insurance?

You can use our new Get an Estimate tool to see if you qualify for savings. Or, you can apply online now to find out if you qualify for any of the programs that help you pay for insurance, including MassHealth, premium tax credits, and ConnectorCare plans.