MassHealth CommonHealth

  • Description
  • Funding History
  • Proposals
  • Expert Commentary

MassHealth CommonHealth covers children and adults with disabilities with incomes that are too high to qualify for MassHealth Standard.

Children with disabilities (including significant behavioral health care needs) whose incomes are too high for MassHealth Standard (up to 150 percent of the federal poverty level) may be eligible for CommonHealth. They can either pay a premium on a sliding scale and receive direct coverage similar to MassHealth Standard, or they can enroll in private insurance, such as a parent’s employer-sponsored plan, and use CommonHealth as supplemental insurance to pay for additional services not covered by the private plan.

Note that MassHealth policy changes sometimes result in program and funding shifts among MassHealth line items in the state budget. For this reason, use caution when comparing funding in these line items from year to year.

Updated, February 2018

According to a national survey (NS-CSHCN 2009/10), 34.3% of families raising children with special health care needs report their insurance is inadequate. Medicaid buy-in programs are particularly important for underinsured children, because they allow families to purchase Medicaid benefits specifically to cover services that are either not covered at all or are covered inadequately by employer-sponsored insurance plans. In addition to promoting more comprehensive health care coverage, Medicaid buy-in programs allow parents to continue to work and maintain earnings and employer-sponsored private coverage.

Bachman, S., et al. State Health Care Financing Strategies for Children with Intellectual and Developmental Disabilities. Intellectual and Developmental Disabilities. Vol. 50, No. 3. June 2012.