11/07/2025
ASK THE INSURANCE GURU:
"Hi Guru,
I just received a notice letting me know that my son was approved for MassHealth CommonHealth, but it stated that I would owe a $400 monthly premium. I don’t understand. I thought MassHealth was free if you had a disability. Can you explain? What can I do?
Nervous Dad"
Hi Nervous Dad,
MassHealth is an income-based system, regardless of disability. However, when eligibility is based on a disability, a monthly premium may apply. This premium is determined based on family size and income and it is on a sliding scale. Things you can consider:
1) Make sure that your entire family is listed on your MassHealth application and that your current income is reflected accurately. To do this you can log into your HIX application www.mahealthconnector.org, call MassHealth (800) 841-2900 or contact the IRC team.
2) If you have primary insurance through an employer you could work with the IRC to see if it meets criteria for Premium Assistance, which can help offset the MassHealth premium. For more information on Premium Assistance check out the IRC fact sheet:https://massairc.org/wp-content/uploads/2025/03/MassHealth-Premium-Assistance.pdf
3) If Premium Assistance is not available for your family, and the cost savings is less than you’ll be paying for MassHealth CommonHealth, you can end your son’s MassHealth within 60 days from the date he was approved, without owing the premium costs. You should call MassHealth and request an administrative closure be placed on his account.
Reminder:
I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.