Is MassHealth the Same as Medicaid? A Clear Guide for Massachusetts Residents

If you live in Massachusetts, you’ve probably heard the term MassHealth and wondered how it relates to Medicaid. The names can be confusing, especially when you’re just trying to figure out what kind of health coverage you have—or might qualify for.

Here’s the key takeaway up front:

MassHealth is Massachusetts’ version of Medicaid (and also includes the state’s Children’s Health Insurance Program, or CHIP).

From there, the details matter. This guide breaks down what that means in everyday terms, how MassHealth works, who might qualify, and how it compares to other types of coverage.

What Is MassHealth?

MassHealth is the name Massachusetts uses for its Medicaid and CHIP (Children’s Health Insurance Program) programs.

In other words:

Medicaid is a federal program that helps people with limited income get health coverage.
Each state runs its own version with its own name and rules.
In Massachusetts, that program is called MassHealth.

So when you hear “MassHealth,” you can think:

“MassHealth = Medicaid (and CHIP) in Massachusetts.”

MassHealth is run by the Massachusetts state government, but it follows broad federal Medicaid rules about who can qualify and what types of coverage must be provided.

How MassHealth and Medicaid Fit Together

To understand the connection, it helps to look at how Medicaid works in general.

Medicaid: The national program

Across the country, Medicaid is designed for:

People with low or moderate income
Many children and families
Pregnant people
Many people with disabilities
Many older adults, especially those needing long-term care

The federal government sets the core rules, then states administer the program with some flexibility. That’s why names, income limits, and covered services can vary from one state to another.

MassHealth: The Massachusetts version of Medicaid

MassHealth is simply what Massachusetts calls its Medicaid program, with some state-specific features and options.

MassHealth:

Follows federal Medicaid requirements
Adds some state-specific benefits, rules, and plan types
Also includes coverage for children through CHIP, even if their family income is higher than traditional Medicaid limits

So if you are on MassHealth, you are on Medicaid (or CHIP) as it exists in Massachusetts.

Who Might Qualify for MassHealth?

Eligibility for MassHealth is based on income, household size, age, disability status, and sometimes other factors like pregnancy or caregiving.

While exact income limits change over time and depend on program type, MassHealth commonly serves:

Children and teens
Low- and moderate-income adults
Pregnant people
People with disabilities
Some older adults, especially those who need long-term care or help with daily activities

Within those groups, there are different MassHealth coverage types with different benefit levels and cost structures.

What Does MassHealth Cover?

Because MassHealth is the state’s Medicaid program, it covers a broad range of medically necessary services. Exact coverage depends on your specific MassHealth plan and eligibility category, but it may include:

Doctor visits and specialists
Hospital care
Emergency services
Preventive care and screenings
Mental health and substance use disorder treatment
Prescriptions
Lab tests and imaging
Some dental and vision services
Therapies (such as physical, occupational, or speech therapy, where eligible)
Home health or long-term services and supports, for those who qualify

Many MassHealth members pay little or no monthly premium, though some may have:

Small copayments for certain services or medications
Limited premiums depending on income and coverage type

The details are specific to your MassHealth plan category, which is listed on your approval notice and member ID information.

Common Types of MassHealth Coverage

MassHealth is not just one single plan. There are multiple coverage types depending on your situation. Names and options can change, but a few broad categories include:

MassHealth Standard – Often the most comprehensive coverage for many low-income adults, children, pregnant people, and some people with disabilities.
MassHealth CommonHealth – Coverage for children and adults with disabilities who may have incomes above standard Medicaid limits.
MassHealth CarePlus – Coverage for some adults with incomes above traditional Medicaid thresholds but within expansion limits.
Limited or restricted coverage – For certain immigration statuses or specific medical needs (for example, emergency care only).

Each one is still MassHealth (and thus part of the state’s Medicaid/CHIP system), but the benefits and cost-sharing can differ.

How MassHealth Differs From Medicare

Many people mix up Medicaid (MassHealth) and Medicare, but they are not the same:

Program	What It Is	Who It’s For	Who Runs It
MassHealth (Medicaid/CHIP)	State-run version of Medicaid and CHIP	People with limited income, children, pregnant people, many with disabilities, some older adults	Joint federal–state (administered by MA)
Medicare	Federal health insurance	Most people 65+ and some younger people with certain disabilities	Federal government only

Key points:

You can have both MassHealth and Medicare if you’re eligible for each. This is often called being “dual eligible.”
If you have both, MassHealth may help cover some costs that Medicare doesn’t fully cover, depending on your eligibility.

How MassHealth Compares With Other Coverage in Massachusetts

In Massachusetts, people often choose between or combine:

MassHealth (Medicaid/CHIP) – Income- and need-based coverage
Employer-sponsored health insurance – Through a job
Individual or family plans – Purchased on the state’s Health Connector
Medicare – For older adults or certain people with disabilities

Some people have MassHealth as secondary coverage, which may help:

Pay premiums or copays
Cover services not fully paid by a primary plan (depending on your MassHealth type)

The exact coordination depends on your specific MassHealth category and other insurance.

How to Find Out If You Have MassHealth (Medicaid)

If you’re unsure whether your coverage is MassHealth or a different plan:

Check your health insurance card
- If it says “MassHealth”, you are in the Massachusetts Medicaid/CHIP system.
- You may also see a managed care plan name, but MassHealth will still be noted.
Review your approval or renewal letters
- These usually state your MassHealth coverage type and may mention Medicaid program rules.
Ask your provider’s office or billing department
- They can often tell you whether your coverage is considered Medicaid (MassHealth) in their system.

Key Things to Know About MassHealth as Medicaid

To summarize the core points:

✅ Yes, MassHealth is Medicaid in Massachusetts (and also includes the children’s health insurance program).
✅ It’s designed for people with limited or moderate income, children, pregnant people, people with disabilities, and some older adults.
✅ Coverage is funded by both the federal government and the state, but administered by Massachusetts under the name MassHealth.
✅ There are different MassHealth plan types with different benefits and rules.
✅ MassHealth is not the same as Medicare, but some people qualify for both.

When You Might Want More Help

Because eligibility and coverage details can be complex, many people:

Contact the Massachusetts state MassHealth customer service line
Speak with a local enrollment assister or navigator
Ask a social worker, case manager, or community health worker for guidance

These options can help you:

Understand which MassHealth category fits your situation
Figure out how MassHealth coordinates with other insurance
Learn what services your specific MassHealth plan may cover

Bottom line:
MassHealth is the Medicaid program for Massachusetts. If you’re enrolled in MassHealth, you are receiving Medicaid (or CHIP) coverage as structured and administered by the state. The name is different, but the program’s role—providing health coverage for people with lower incomes and certain needs—is the same.