By Marc Gilman

For additional information, please call: (800) 927-9326 or email:

Key Takeaways:

• MassHealth’s 2026 income standards took effect March 1, 2026 — not January 1 — so applications filed earlier in the year were still evaluated under 2025 limits.

• As of January 1, 2026, Senior Care Options (SCO) enrollees must have both Medicare Part A and Part B, plus MassHealth Standard, to remain in an SCO plan. Members without both Parts were transitioned to MassHealth Fee-for-Service, keeping MassHealth Standard but losing SCO’s care coordination.

• The 300% FBR limit used for long-term care and Home and Community-Based Services programs rose in 2026 due to the SSI cost-of-living adjustment, to $2,982/month.

• There’s still no asset test for MAGI-based populations (children, pregnant women, parents, expansion adults) — only income is counted for those groups.

• Seniors and people with disabilities remain under non-MAGI rules, which still include a $2,000 individual asset limit.

MassHealth updates its eligibility standards every year, but 2026 brought a few changes worth knowing about beyond the usual cost-of-living bump — particularly if you or a family member is on Senior Care Options, or applying for long-term care coverage.

New Income Standards Took Effect March 1, 2026

Unlike many benefit programs that update on January 1, MassHealth ties its income standards to the federal poverty guidelines on a March cycle. That means anyone who applied in January or February 2026 was still evaluated against 2025 limits — and if you were denied coverage during that window for being just over the limit, it may be worth reapplying now that the updated figures are in effect.

Here are the current monthly income standards by household size, effective March 1, 2026:

Household of 1 — 100% FPL: $1,330/month · 133% FPL: $1,769/month · 150% FPL: $1,995/month

Household of 2 — 100% FPL: $1,804/month · 133% FPL: $2,399/month · 150% FPL: $2,705/month

Household of 3 — 100% FPL: $2,277/month · 133% FPL: $3,028/month · 150% FPL: $3,415/month

Household of 4 — 100% FPL: $2,750/month · 133% FPL: $3,658/month · 150% FPL: $4,125/month

Most non-disabled adults qualify for MassHealth Standard or CarePlus around 133% of the Federal Poverty Level. Pregnant women and children are evaluated against higher thresholds under separate MassHealth programs.

Senior Care Options Now Requires Both Medicare Parts A and B

This is the change most worth flagging if you work with dually eligible clients. As of January 1, 2026, Senior Care Options (SCO) — the integrated care program for people with both Medicare and MassHealth — requires enrollees to have both Medicare Part A and Part B, along with MassHealth Standard, to stay enrolled.

If you’re already dual-eligible (Medicare + MassHealth), nothing changes — you continue in SCO as before.

If you only had MassHealth Standard, with no Medicare, you were automatically transitioned to MassHealth Fee-for-Service on January 1, 2026. You keep MassHealth Standard coverage, but lose SCO’s managed care benefits and care coordination. Most SCO providers are also enrolled in MassHealth Fee-for-Service, so provider continuity is generally possible — worth confirming through the MassHealth provider directory.

If you were eligible for Medicare but hadn’t enrolled, the key date was December 31, 2025 — enrolling in Medicare by that deadline was what determined whether you stayed in SCO or were moved to Fee-for-Service. MassHealth sent two advance notices to affected members: one 90 days before the change and one 30 days before.

If you think you may have missed this deadline, MassHealth Customer Service (1-800-841-2900) can confirm your Qualified Medicare Beneficiary (QMB) status, and your local Social Security Administration office can help you enroll in Medicare going forward.

(Source: 2026 SCO Eligibility Changes, Mass.gov. The eligibility change was enacted through Section 45 of Chapter 9 of the Acts of 2025, which amended SCO’s governing statute, M.G.L. Chapter 118E, Section 9D. Note: as of August 1, 2025, new SCO enrollment was already limited to members with both Medicare Parts A and B — January 1, 2026 was specifically when existing members without both Parts were transitioned out.)

Long-Term Care and HCBS Income Limits Increased

The 300% FBR (Federal Benefit Rate) standard — used to determine eligibility for Home and Community-Based Services and certain long-term care programs, including the Frail Elder Waiver — rose in 2026 in line with the annual SSI cost-of-living adjustment. The Federal Benefit Rate itself is now $994/month, putting the 300% FBR limit at $2,982/month.

If you or a family member was just over the income limit for these programs in 2025, it’s worth checking again under the 2026 figures — you may now qualify.

What Hasn’t Changed

A couple of longstanding MassHealth rules remain the same and are still worth knowing:

• No asset test for MAGI populations. Children, pregnant women, parents/caretakers, and expansion adults are still evaluated on income alone.

• Asset limits still apply for seniors and people with disabilities. Non-MAGI applicants — including most people applying for MassHealth Standard based on age or disability — still face a $2,000 individual asset limit.

What To Do Next

If you were denied MassHealth coverage earlier in 2026, were transitioned off an SCO plan to Fee-for-Service, or think you might now qualify for a long-term care program under the updated limits, it’s worth a fresh look rather than assuming last year’s answer still applies.

If you need further information about how these 2026 changes might affect your MassHealth eligibility, we’re here to help — no cost, no obligation.

For additional information, please call: (800) 927-9326 or email: