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Understanding Medicaid

Your Medicaid questions answered: Who is eligible, how to apply, and more

October 1, 2022
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Medicaid is a program that is run jointly by the federal and state governments. It provides coverage for healthcare and other related services to people who are eligible due to any number of circumstances.

Some states have their own version of Medicaid. For example, in Massachusetts, Medicaid is called MassHealth. In Rhode Island, Medicaid is also called Rhode Island Medical Assistance Program. Michigan Medicaid serves Michiganders.

Commonly Asked Questions About Medicaid

Medicaid pays for healthcare for certain low-income residents. Benefits may be paid directly to you, or by paying part or all of your health insurance premiums.

To be eligible for Medicaid, you must be a U.S. national, citizen, permanent resident, or legal alien. Your income must fall below a certain yearly amount, and you must be in need of assistance to pay for healthcare or insurance.

Qualifying for Medicaid is based on income, and it differs by state.

Income eligibility is determined by your taxable income. It is also determined by certain deductions. Examples include non-taxable Social Security benefits, individual retirement contributions, and interest earnings.

Click here1 for the Massachusetts Medicaid (Mass Health) eligibility tool.
Click here1 for the Rhode Island Medicaid eligibility tool.
Click here1 for the Michigan Medicaid eligibility tool.

If your income increases, there is the possibility that you will no longer be eligible for Medicaid. In this case, you may still qualify to purchase coverage through a private health insurance company. In the event of an income change—whether it goes up or down—you must report it to the state Medicaid office. They will let you know what documents you need to provide and if your eligibility has changed. If you become eligible for Medicaid again, you will have to re-apply.

Medicaid covers a wide range of services to meet the diverse needs of the people it serves. Under the federal Medicaid law, there are certain services that are required to be covered. Many states cover additional optional services. Some examples are prescription drugs, physical therapy, eyeglasses, and dental care.

Click here1 to see a full listing of required and optional covered benefits.

Dual eligible is a term that applies to people who are eligible for both Medicare and Medicaid. That means you qualify to receive health coverage from two sources:

  • Medicare for most preventive, primary, and acute health care services; and prescription drugs.
  • Medicaid for long-term health care services, certain mental health services, and Medicare premiums and copayments.

For people who are dual-eligible, CCA offers a special type of Medicare Advantage HMO plan. This plan is known as a Dual Eligible Special Needs Plan (D-SNP).

In Massachusetts, our D-SNP plan is called CCA Senior Care Options (HMO D-SNP). In Rhode Island and Michigan, it is called CCA Medicare Maximum (HMO D-SNP). These plans provide all the coverage of Medicaid and Medicare. They also provide additional benefits to meet certain health care needs and to save you money.

Click here for more information on CCA Senior Care Options.

Click here for more information on CCA Health Rhode Island Medicare Maximum.

Click here for more information on CCA Health Michigan Medicare Maximum.

In Massachusetts:

You must complete the Application for Health Coverage for Seniors and People Needing Long-Term Care Services,1 which is available online. You may also apply by calling the MassHealth Customer Service Center at 800-841-2900.

To complete the application, you will need:

  • Social Security numbers, if you have them, for every household member who is applying,
  • Proof of income and assets,
  • Proof of any health insurance that you are currently enrolled in or have access to, and
  • Information about or proof of citizenship/national status or immigration status.

You may mail in your completed form to:

MassHealth Enrollment Center
Central Processing Unit
P.O. Box 290794
Charlestown, MA 02129-0214

In Rhode Island:

You may apply online, by phone, or by mail.

  • Visit the Programs and Services page of the Rhode Island Health and Human Services website:
  • Call the Department of Health and Human Services at 1-855-840-4774, 8 a.m. to 6 p.m., Monday – Friday
  • Complete the Application for Assistance1 and mail it to: Department of Human Services, P.O. Box 8709, Cranston, RI 02920-8787.

In Michigan:

More questions about Medicaid?

1 When you click this link, you will leave the Commonwealth Care Alliance website.


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