Introduction

(A) Categorical Requirements and Financial Standards. 130 CMR 519.000 explains the categorical requirements and financial standards that must be met to qualify for a MassHealth coverage type. The rules of financial responsibility and the calculation of financial eligibility are detailed in 130 CMR 520.000: MassHealth: Financial Eligibility. (B) MassHealth Coverage Types. The MassHealth coverage types available to individuals 65 years of age and older, institutionalized individuals, and those who would be institutionalized without community-based services are the following: (1) MassHealth Standard; (2) MassHealth Limited; (3) Medicare Savings Program (MSP) for Qualified Medicare Beneficiaries (QMBs) (Senior Buy-in); (4) MSP for Specified Low-income Medicare Beneficiaries (SLMBs) and Qualifying Individuals (QIs) (Buy-in); (5) MassHealth CommonHealth; and (6) MassHealth Family Assistance. (C) Determining Eligibility. The MassHealth agency determines eligibility for the most comprehensive coverage available to the applicant, although the applicant has the right to choose to have eligibility determined only for MSP for QMBs or MSP for SLMB and QI coverage. If no choice is made by the applicant, the MassHealth agency determines eligibility for all available coverage types.