For many Massachusetts residents, Social Security benefits provide a vital source of income. At the same time, MassHealth offers healthcare coverage to those who meet certain financial requirements. The way MassHealth counts Social Security income can affect eligibility, sometimes pushing individuals over the limit for coverage. While some benefits are included in income calculations, others may be excluded. This can create confusion for those who depend on both. If you receive Social Security and want to ensure continued access to MassHealth, it’s important to understand how these programs interact and what options may be available to manage your income.
How MassHealth Calculates Income
MassHealth looks at your total income to determine eligibility. Some types of income count toward the limit, while others do not.
MassHealth counts:
- Wages from a job or self-employment
- Social Security benefits (except Supplemental Security Income)
- Unemployment benefits
- Rental income, dividends, and retirement withdrawals
MassHealth does not count:
- Supplemental Security Income (SSI)
- Some veterans’ benefits
- Child support received
- Certain medical expense deductions (for some applicants)
If your income is too high for standard MassHealth coverage, there may be options to help you qualify, such as deductions or income trusts. Understanding what counts toward the limit can help you plan for continued coverage.
Does Social Security Count as Income?
MassHealth considers most Social Security benefits as income when determining eligibility. However, whether these benefits affect your coverage depends on the type of Social Security you receive.
Counted as Income:
- Social Security retirement benefits – Monthly payments based on your work history.
- Social Security Disability Insurance (SSDI) – Benefits for those with disabilities who have a work history.
Not Counted as Income:
- Supplemental Security Income – A need-based program for low-income individuals who are elderly, blind, or disabled.
- Some dependent benefits – In certain cases, Social Security benefits received by children or dependents may not be fully counted.
Managing Income to Maintain MassHealth Eligibility
If your Social Security benefits or other income put you over the MassHealth limit, there are ways to adjust your finances to stay eligible. Some options depend on the type of MassHealth coverage you need.
Some ways to manage income include:
- Income trusts – Certain applicants, especially those needing long-term care, may be able to place excess income into a Qualified Income Trust (Miller Trust) to meet eligibility requirements.
- Medical expense deductions – Some out-of-pocket healthcare costs can be deducted from countable income, helping individuals qualify for benefits.
- Spousal protections – If one spouse needs MassHealth for long-term care, there are rules that allow the other spouse to keep a portion of the household income.
- Adjusting income sources – Shifting certain payments or structuring retirement withdrawals differently may help manage income levels.
Planning ahead can prevent unexpected issues with eligibility. If you rely on Social Security and are close to the income limit, exploring available options can help you keep MassHealth coverage without sacrificing other financial needs.
Get the Right Plan for Your MassHealth Eligibility
Understanding how Social Security benefits affect MassHealth eligibility can help you avoid losing coverage. At Surprenant & Beneski, P.C., we can guide you through your options and create a plan that works for you. Call us today to schedule a consultation.