Residence Requirements

As a condition of eligibility, an applicant or member must be a resident of the Commonwealth of Massachusetts. (A) Unless otherwise specified (1) individuals 21 years of age or older are residents of the Commonwealth if they are living in the Commonwealth and either (a) intend to reside in the Commonwealth, with or without a fixed address; or (b) have entered the Commonwealth with a job commitment or are seeking employment, whether or not they are currently employed; or (2) individuals 21 years of age or older who are not capable of stating intent as defined in 42 CFR 435.403(c) are residents of the Commonwealth if they are living in the Commonwealth. (3) For any other non-institutionalized individuals 21 years of age or older not subject to 130 CMR 503.002(A)(1) or (2), their residence is determined in accordance with 45 CFR 233.40, the rules governing residence under the Transitional Assistance to Families with Dependent Children (TAFDC) program. (B) Unless otherwise specified (1) individuals younger than 21 years old are residents of the Commonwealth if they are capable of indicating intent and are either married or emancipated from their parents and meet the requirements of 130 CMR 503.002(A)(1); or (2) individuals younger than 21 years old not described in 130 CMR 503.002(B)(1) are residents of the Commonwealth if they are (a) living in the Commonwealth, with or without a fixed address; or (b) living with their parent or caretaker who is a resident of the Commonwealth in accordance with the requirements of 130 CMR 503.002(A)(1). (C) Individuals of any age who are receiving a state supplementary payment (SSP) are residents of the Commonwealth if the Commonwealth is the state paying the SSP. (D) Individuals of any age who are receiving federal payments for foster care and adoption assistance under title IV-E of the Social Security Act are residents of the Commonwealth if the Commonwealth is the state where the individuals live. (E) (1) The individual's residency is considered verified if the individual has attested to Massachusetts residency and the residency has been confirmed by electronic data matching with federal or state agencies or information services. (2) If residency cannot be verified through electronic data matching or there is conflicting information, the MassHealth agency may require documentation to validate residency. (F) Acceptable proof of Massachusetts residency includes the following, as well as any other verification allowed as determined by the MassHealth agency: (1) copy of deed and record of most recent mortgage payment (if mortgage is paid in full, provide a copy of property tax bill from the most recent year); (2) current utility bill or work order dated within the past 60 days; (3) statement from a homeless shelter or homeless service provider; (4) school records (if school is private, additional documentation may be requested); (5) nursery school or daycare records (if school is private, additional documentation may be requested); (6) Section 8 agreement; (7) homeowner’s insurance agreement; (8) proof of enrollment of custodial dependent in public school; (9) copy of lease and record of most recent rent payment; or (10) affidavit supporting residency signed under pains and penalties of perjury that states the individual is not visiting Massachusetts for personal pleasure or to receive medical care in a setting other than a nursing facility. (G) Examples of applicants or members who do not meet the residency requirement for MassHealth are (1) individuals who came to Massachusetts for the purpose of receiving medical care in a setting other than a nursing facility, and who maintain a residence outside Massachusetts; (2) individuals visiting Massachusetts for personal pleasure, who maintain a residence outside Massachusetts; and (3) individuals whose whereabouts are unknown. (H) Inmates of penal institutions may not receive MassHealth benefits except under one of the following conditions, if they are otherwise eligible for MassHealth: (1) they are inpatients in a medical facility; or (2) they are living outside the penal institution, are on parole, probation, or home release, and are not returning to the institution for overnight stays; or (3) they are in their pre-release period under the MassHealth Medicaid and Children’s Health Insurance Plan (CHIP) Section 1115 Demonstration, or the Consolidated Appropriations Act, 2023 (CAA, 2023), or Section 1001 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (“the SUPPORT Act”) Public Law 115-271.