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Fund Your AT > Medically Necessary > Adults

Funding for Medically Necessary AT for Adults

Help Accessing Services:

Independent Living Centers (ILCs)

ILCs provide peer support and advice. The ILCs are staffed with people with disabilities who have experience navigating health care networks as professional and self-advocates. Read more.

Funding Sources:

MassHealth (Medicaid)

Federal and state-funded health insurance for very low to medium income people living in Massachusetts is available through the various programs of MassHealth. MassHealth can provide health care benefits directly or pay all or part of an individual or family's health-insurance premium.

MassHealth Standard

Includes coverage for adults with disabilities (all SSI recipients), pregnant women, parents and other caretaker relatives of children (all TAFDC recipients); income restrictions vary by category (up to 200% of the federal poverty level). DME is covered. Read more.

MassHealth CommonHealth

Includes coverage for adults with disabilities who are over-income for MassHealth Standard and have no private insurance. There is no upper-income limit or asset test. Premiums are determined on a sliding scale. DME is covered. Read more.

MassHealth Family Assistance

Includes coverage for income-eligible adults (up to 200% of the federal poverty level) who cannot get MassHealth Standard or MassHealth CommonHealth. Provides access to either private or public health insurance. DME coverage can vary by plan.
Read more.

MassHealth Basic

Provides long-term unemployed adults who are clients of the Department of Mental Health (or on the waiting list for services), and people receiving Emergency Aid to the Elderly, Disabled and Children (EAEDC) cash assistance, with access to very basic public or private health insurance. DME is usually covered. Read more.

MassHealth Essential

Provides long-term unemployed adults who are not eligible for MassHealth Basic (not clients of the Department of Mental Health, and not EAEDC cash recipients) with a stripped-down package of MassHealth insurance benefits. Only prosthetic and podiatrist services (but not equipment) is covered. Read more.

Commonwealth Care

State-subsidized health insurance is available to adult residents of Massachusetts (US citizens, nationals, and legal aliens) who are uninsured and meet income guidelines (up to 300% of the federal poverty level). DME is a covered benefit: co-pays and premiums vary by plan type. Read more.

Medicare

This federal program includes limited health insurance benefits to some SSDI recipients (disabled adults), and all people with end-stage renal disease, in addition to seniors. Some DME is covered under "home health" through Medicare Part A, and more DME benefits are available under the optional Part B coverage. Read more.

Private Insurance

Private health insurance is the "payer of first resort" for DME, if you have it. Advice and resources are provided here for understanding your coverage, obtaining "prior approval," and appealing denials. Read more.