MASSHEALTH PREMIUM ASSISTANCE ELIGIBILITY AND PREMIUM CHANGES

Due to the recent health-care reform legislation, MassHealth has changed the eligibility requirements for premium assistance for adults to increase the income eligibility to less than or equal to 300% of the federal poverty level (FPL) and to include the requirement that the adult’s employer or the family member’s employer has not, in the last six months, provided health insurance coverage for which the adult is eligible.

MassHealth has also changed the estimated member share of the premium from one to three groups.

1. If the family group’s income is 100% through 200% of the FPL, the premium is $27 per covered adult in the family group.
2. If the family group’s income is above 200% through 250% of the FPL, the premium is $53 per covered adult.
3. If the family group’s income is above 250% through 300 percent of the FPL, the premium is $80 per covered adult.

These regulations are effective retroactively to October 1, 2006.

-Adapted from: MassHealth Eligibility Letter 164, July 15, 2007.

09/07