1. (A) MassHealth. The MassHealth agency formulates requirements and determines eligibility for all MassHealth coverage types.

2. (B) Other Agencies.

   1. (1) Department of Transitional Assistance (DTA).

      1. (a) The DTA administers the Transitional Aid to Families with Dependent Children (TAFDC) Program. Persons who meet the requirements of § 1931 of Title XIX (42 U.S.C. § 1396u-1) are automatically eligible for Standard coverage.
      2. (b) DTA also administers the Emergency Aid to the Elderly, Disabled and Children (EAEDC) Program. The MassHealth agency provides MassHealth to those persons receiving EAEDC cash assistance as follows: 1. MassHealth Standard: children younger than 19 years old, ; young adults 19 and 20 years old who are citizens, qualified noncitizens, qualified noncitizens barred, and nonqualified individuals lawfully present; parents and caretakers who are citizens or qualified noncitizens; adults 21 through 64 years old who are citizens or qualified noncitizens; children younger than 19 years old;
   2. 2. MassHealth Family Assistance: children younger than 19 years old, young adults 19 and 20 years old who are nonqualified persons living under color of law (PRUCOLs), parents and caretakers who are qualified noncitizens barred, nonqualified individuals lawfully present, nonqualified PRUCOLs, and adults 21 through 64 years old who are qualified noncitizens barred, nonqualified individuals lawfully present, and nonqualified PRUCOLs.

   3. (2) Social Security Administration (SSA). The SSA administers the Supplemental Security

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Trans. by E.L. 251 Rev. 02/13/2026

130 CMR 501.000: HEALTH CARE REFORM: MASSHEALTH: GENERAL POLICIES

Income (SSI) program and determines the eligibility of disabled individuals. Individuals receiving SSI are automatically eligible for Standard coverage. Individuals without health insurance are provided choices of enrollment in a MassHealth managed care provider, SCO, or ICO in accordance with 130 CMR 508.000: MassHealth: Managed Care Requirements. (3) Health Connector. The Health Connector is Massachusetts’s health insurance marketplace where individuals, families, and small businesses can shop among qualified health insurance carriers and choose a health insurance plan. The Health Connector administers qualified health plans (QHPs), premium tax credits (PTC), and the ConnectorCare program. The single, streamlined application is used to determine eligibility for both Health Connector and MassHealth programs as described in 130 CMR 502.000: Health Care Reform: MassHealth: The Eligibility Process. The Health Connector and MassHealth also coordinate eligibility notices and eligibility appeals.