MassHealth Buy-In Eligibility: Income Limits and the Asset Test Removal

The most common reason people do not apply for Massachusetts's Medicare Savings Programs is a wrong assumption about eligibility. They either believe their savings disqualify them or think the income cutoff is lower than it actually is. Both of those barriers were removed — one by a 2024 policy change, the other by Massachusetts setting limits far above the federal floor.

The Asset Test Is Gone

On March 1, 2024, Massachusetts eliminated the asset test for all three MSP tiers — QMB, SLMB, and QI. Savings accounts, retirement funds, vehicles, real estate, and life insurance are completely disregarded when MassHealth determines MSP eligibility.

Before this change, the resource limits tracked the federal standard: $9,430 for an individual and $14,130 for a couple. That threshold stopped many eligible seniors from applying — particularly those with a modest emergency fund or a small IRA they were afraid to report.

Under current rules, a senior with $100,000 in a savings account qualifies for MSP coverage on income alone. Asset documentation is not required and should not be submitted with the application.

2026 Income Limits

Massachusetts sets MSP income thresholds well above the federal minimums. The limits update each March 1 when new federal poverty level figures take effect.

For married couples living together, MassHealth combines both spouses' incomes and applies couple standards regardless of whether one or both have Medicare. The couple QI ceiling is $4,058 per month.

Compare that to the federal baseline: 100% FPL for QMB ($1,330/month), 120% for SLMB, and 135% for QI. Massachusetts nearly doubles the QMB threshold and pushes QI to 225%. Tens of thousands of residents qualify in Massachusetts who would not in states using the federal minimum.

How MassHealth Counts Income

MassHealth does not use your parent's take-home pay or the net Social Security deposit. It starts with gross income — the full Social Security benefit before Medicare premiums or tax withholdings are deducted — and applies two standard disregards:

1. $20 unearned income disregard: Subtracted from total monthly unearned income (Social Security, pensions, annuities, VA disability, interest, dividends).
2. $65 earned income disregard plus 50% reduction: For working applicants, MassHealth deducts $65 from gross wages, then disregards half of the remainder.

A practical example: a single person receives $2,400 per month in Social Security and a $150 pension. Gross unearned income is $2,550, minus the $20 disregard equals $2,530 countable income. That is just above the QMB ceiling ($2,527) but well below the QI ceiling ($2,993), so they qualify for QI — and their Part B premium is fully covered.

The Social Security COLA Safeguard

Every January, Social Security applies a Cost-of-Living Adjustment (COLA) that increases benefit payments. Because the state FPL income limits do not update until March 1, there is a two-month window where a COLA increase could push someone over the old threshold. Massachusetts handles this by applying a mandatory income disregard for the COLA amount from January through February. No one loses MSP eligibility during that gap because of a routine COLA increase.

Separated or Institutionalized Spouses

If spouses live apart permanently, or one spouse resides in a long-term care facility, MassHealth evaluates the applicant as an individual household — counting only the applicant's income against the individual limit. This matters when a spouse's income would push the couple over the threshold but the applicant's own income is low enough to qualify individually.

Checking Eligibility

The quickest screen: take your parent's gross monthly Social Security benefit, add any pension income, subtract $20, and compare to the limits above. If the number is under $2,993 for an individual, they likely qualify for at least the QI tier.

The Massachusetts Medicare Savings Programs Guide includes a step-by-step eligibility worksheet that handles the income calculations, household-size rules, and earned income disregards — so you know exactly which tier your parent qualifies for before submitting the application.

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