Getting a MassHealth premium waiver or payment plan

Clients in MassHealth premium-paying plans who are experiencing 'extreme financial hardship' may apply for a hardship waiver or reduction of their premium. Clients must call the MassHealth Customer Service Center at 1-800-841-2900 to request a waiver. MassHealth will then send the applicant a waiver request form, which must be returned within two weeks. Decisions about waivers and reductions are made by MassHealth, and may be valid for up to six months. At that time, clients may submit another request.

MassHealth considers the following criteria as evidence of 'extreme financial hardship:'

• Homelessness
• 30 days in arrears in rent or mortgage payments
• Facing current eviction or foreclosure notice
• A shut-off warning or current shut-off or refusal to deliver essential utilities (gas, electric, oil, water, or telephone)
• Medical and/or dental expenses (including medical debt) that require the family group to spend more than 7.5% of its gross annual income
• A significant, unexpected increase in essential expenses within the last six months

Clients who have past due balances for their premium-paying MassHealth plans may request a payment plan, but may not use the premium waiver process to eliminate past due balances. Clients must call MassHealth Customer Service to request a payment plan.

Clients who feel they are unfairly denied a waiver, reduction or payment plan request may contact Health Law Advocates for assistance.

• Click here for MassHealth regulations on hardship waivers. (PDF)
• Click here for MassHealth regulations on payment plans. (PDF)