Can I get MassHealth as a FT grad student with a small income?
March 27, 2012 10:42 AM   Subscribe

I'm a full-time graduate student & MA resident about to turn 26 in August and lose my parent's health insurance. My school offers health insurance, but it costs $3000 for the year, which I cannot afford. I have looked into applying for MassHealth but it seems like I am not guaranteed to be approved since I do have coverage available from my school.

I have checked the MA Health Connector website, and there is no info for someone in my situation.

To complicate matters, I will have a FT (temporary) job when I apply for MassHealth this summer, but the job will end in late August. My school year begins in Sept.

This is a huge headache, and ironically I'm studying a health profession and cannot find anyone that knows the answer. My school is not helpful.

Has anyone had experience with this or knows the correct way to proceed?

Thank you
posted by kmavap to Health & Fitness (12 answers total)
Well I don't know anything about MassHealth, but I lost access to health insurance several years ago and just got it again this year (through school). I managed to pay out of pocket because I am relatively healthy and found a doctor who has discounted fees for those without insurance. I also found a dentist (when I needed wisdom teeth pulled) who was cash-only but much cheaper. So depending on your situation you may be able to manage without until you get insurance again. Even if you need urgent care, you can plead poverty at the ER (if it is true)... my friend did this and was eligible because of her income, and received the ER care charge-free.

I'm not advocating not having health insurance, because obviously it's better to have it just in case.
posted by DoubleLune at 10:52 AM on March 27, 2012

"MassHealth compares your family's monthly income (before taxes and other deductions) to the applicable federal poverty level. If you get income on a weekly basis, we multiply the weekly income by 4.333 to get a monthly amount."

When they say "family," they mean household.

So you can be eligible, then not be eligible, then be eligible again.

If you cannot afford the $250/month of your school's health insurance, then it is likely you are eligible for MassHealth, at least part of the year. (Or you need to rebudget.)

Also, yes. You can go without health insurance. You are young! Some of us have done it for decades at a time.

You can also get health insurance, through Aetna and others, that covers emergencies, hospitalizations, etc., for around $150/month. That's basically "bankruptcy insurance": it just ensures that you won't go bankrupt if you get cancer or several broken bones, etc.
posted by RJ Reynolds at 10:54 AM on March 27, 2012 [1 favorite]

Yes, kmavap, you should qualify for MassHealth. I was on it when I graduated from college (before they upped the amount of time you're covered under a parent's plan--grr!). I was temping full-time but still qualified. If it helps any, I chose Commonwealth Care for my plan, and it was a relatively simple process to apply.

Since you will get a tax penalty in MA if you don't have health insurance, don't go without it. Go ahead and apply, and call MassHealth directly if you have questions. Despite feeling like I was on hold forever each time I called, I was able to get all of my questions answered when I was going through the application process.

Good luck!
posted by Maya Cecile at 11:01 AM on March 27, 2012 [2 favorites]

I certainly know people who are on MassHealth because they can't afford the cost of their school insurance, or other insurances available to them that are priced higher than MassHealth. Once you get someone on the phone, they will be likely to be familiar with your question.
posted by Sidhedevil at 11:08 AM on March 27, 2012

Call the contact number on the MassHealth Connector Web site; the staff member I spoke to a few weeks ago seemed pretty knowledgeable.

As others have said, I think you would qualify (and as Maya Cecile noted, you'll pay a tax penalty if you don't have any insurance).
posted by Currer Belfry at 11:15 AM on March 27, 2012 [1 favorite]

How much is the penalty for no insurance?

Residents without MCC health insurance face monthly penalties. The penalties add up each month without health insurance, and must be paid at tax filing time. Short gaps in coverage (up to three months) are allowed without a tax penalty.

Penalties are based on ½ the cost of the lowest-priced Commonwealth Choice plan available to you. The penalties vary by age and income, based on percentages of the Federal Poverty Guidelines (FPG). People with incomes at or below 150% of the FPG do not have to pay a penalty if uninsured.
There's more information at the link. Basically, it seems that not getting any insurance will cost you half as much as getting the cheapest available insurance would, except that a three-month gap in insurance, or income approaching the poverty line would not be penalized.
posted by Kirth Gerson at 12:14 PM on March 27, 2012

The idea that you can go without insurance in MA is false -- there is a requirement that you be insured.
posted by ellF at 12:35 PM on March 27, 2012

Do you have student loans? Can you roll insurance in with your loans? I'm sure there are worse stories out there but when I was without health insurance, I got pink eye so I had to spend about $100 out of pocket to see a doctor, then another $80 for antibiotics that would have cost about $5 if I had had health insurance. Then I got a yeast infection due to the antibiotics and needed to make two trips to Planned Parenthood ($100 each) and more medicine ($50). This whole exercise was incredibly stressful, took time away from my job search, and would have been much easier and cheaper if I had had health insurance.
posted by kat518 at 12:37 PM on March 27, 2012

You are unfortunately not eligible if your school offers you insurance, whether you can afford it or not. From the MassHealth application (I don't know how to link to the PDF):
"you will not be eligible for Commonwealth Care if you have or can get insurance from a government insurance program including, but not limited to: - Medicare; - TRICARE (dependents of the military); - Medical Security Program (through the Division of Unemployment Assistance); or - student health insurance from a Massachusetts school".
Similar info is at

I know several people who have tried and failed to get it because of similar situations.

The summer employment probably won't matter if you school offers coverage that extends into that period.
posted by ninekinds at 1:23 PM on March 27, 2012

That's weird. The link was supposed to be to:
posted by ninekinds at 1:24 PM on March 27, 2012

The idea that you can go without insurance in MA is false -- there is a requirement that you be insured

The requirement is that you be insured or pay a tax penalty.

ninekinds, I am pretty sure (but the MassHealth staff will confirm or deny it) that the "Massachusetts school" referred to under the "government insurance" disqualification refers to a Massachusetts state institution, not to private institutions. MIT's student insurance isn't "government insurance", for instance.
posted by Sidhedevil at 2:02 PM on March 27, 2012

Just to clarify, MassHealth is the name for MA Medicaid program. It's unlikely you will qualify for Medicaid... Commonwealth Care is the name of the state subsidized insurance program you would be a part of. Applying can be tricky and take a long long time. For me, it took a full six months for me to be approved with several rounds of verification paperwork. I found the phone support people surprisingly informed and helpful though navigating the phonetree will make you want to end it all. Get the number and call them, explain your situation and they should be able to give you an answer. A couple of points:

If your income is low, it is likely that the penalty will be waived for not having insurance.

It is likely that your school requires insurance for enrollment.

It is possible to spoof the school insureance reqs by getting a policy number and then cancelling the policy.

Not having insurance isa playing "American" roulette with your life. I dont recommend it. If you, like me, find yourself in ER in MA without insurance, definitely plead poverty at the hospital. dont agree to pay anything. The hospital has staff whose job it is to deal with this and they haveq every incentive to help you.

If Obamacare survives, everyone in the US is going to discover the fun of navigating edge cases of a complicated complicated setup. Its really hard to tell just what you qualify for and when, e only thing to do is apply and hope for the best...
posted by at 5:49 AM on March 28, 2012

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