651 CMR, § 15.04 - Eligibility

(1) A Member of the Plan must be a Resident of the Commonwealth who is not eligible for MassHealth and:

(a)

1. is 65 years of age or older and is not eligible for Medicare; or

2. is 65 years of age or older and is eligible for Medicare and has Gross Household Income less than or equal to 500% of the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services; or

(b) has a Gross Annual Household Income less than or equal to 188% of the Federal Poverty Level, does not work more than 40 hours per month and meets:

1. the disability requirement of the CommonHealth program as referenced under M.G.L. c. 118E, § 9A(2)(h), notwithstanding the income eligibility requirements under M.G.L. c. 118E, §9A(2)(h); or

2. the disability requirements of the CommonHealth program as referenced under M.G.L. c. 118E, § 16, notwithstanding the income eligibility requirement under M.G.L. c. 118E, §9A(2)(h); or

3. the disability requirements of the CommonHealth program as referenced under M.G.L. c. 118E, § 16A.

(2) The Plan may require verification or re-verification of any eligibility requirement at any time.

(3) Beginning January 1,2006, in order to be eligible for the Plan, individuals who are eligible for Medicare must be enrolled in a Medicare Part D Plan.

Notes

651 CMR, § 15.04

Amended by Mass Register Issue 1327, eff. 12/2/2016. Amended by Mass Register Issue 1408, eff. 1/10/2020.