What disability programs are available in Massachusetts

Massachusetts offers several programs for people with disabilities, but they operate under different rules and serve different situations. The largest is Social Security Disability Insurance (SSDI), which is federal and available to anyone who meets Social Security's definition of disability, regardless of where they live. Massachusetts also runs its own programs: Supplemental Security Income (SSI) (federal but with state supplements), MassHealth (the state Medicaid program), and the Massachusetts Rehabilitation Commission (MRC), which helps people with disabilities return to work.

Each program has its own income and resource limits, its own definition of disability, and its own rules about what you can earn while receiving benefits. SSDI is based on your work history; SSI is based on financial need. MassHealth covers medical costs; MRC provides vocational training and job placement. Understanding which program fits your situation—or whether you might may have access to for more than one—is the first step.

Key Takeaways

  • SSDI is federal and based on your work history; SSI is federal but needs-based and includes a Massachusetts state supplement that adds money to the federal payment.
  • MassHealth covers medical expenses for people with disabilities and has different income limits than SSDI or SSI.
  • The Massachusetts Rehabilitation Commission helps people with disabilities train for and find work, and can pay for education, assistive technology, and job coaching.
  • You can receive SSDI and MassHealth at the same time, and work incentives allow you to earn money while keeping some or all of your benefits.
  • The Social Security Administration and MassHealth have different definitions of disability, so you might be found disabled under one program but not another.

SSDI in Massachusetts: How your work history determines your benefit

To receive SSDI in Massachusetts, you must have worked long enough and recently enough to have built up a Social Security record. The Social Security Administration (SSA) looks at your age and the year you became disabled to decide how many work credits you need—typically 40 credits total, with at least 20 earned in the 10 years before you became disabled. One credit is earned for roughly every $1,550 in annual wages (this amount changes each year).

Your SSDI payment amount is based on your average lifetime earnings, not on your current need. Two people with the same disability can receive very different amounts depending on how much they earned while working. In 2024, the average SSDI payment is around $1,550 per month, but this varies widely. Once you are approved, your payment stays the same unless Social Security adjusts it for cost-of-living increases or you return to work.

Massachusetts does not add a state supplement to SSDI (unlike SSI). However, if you receive SSDI, you automatically become covered by Medicare after 24 months, which means your medical costs are covered by federal insurance rather than by the state.

SSI and the Massachusetts state supplement: Need-based payments with state add-ons

Supplemental Security Income (SSI) is a federal program for people with disabilities who have little or no income and few resources. Unlike SSDI, SSI does not require a work history. The federal SSI payment in 2024 is $943 per month for an individual, but Massachusetts adds its own state supplement on top of that amount. The state supplement varies depending on your living situation—whether you live alone, with family, in a group home, or in an institution—and ranges from about $70 to $150 per month.

To receive SSI in Massachusetts, your countable resources must be under $2,000 (or $3,000 if you are married). Countable resources include cash, bank accounts, stocks, and some property, but not your home, one vehicle, or certain personal items. Your monthly income limit is also strict: in 2024, the federal limit is $943 for an individual, though the state supplement raises your total payment.

Many people receive both SSDI and SSI at the same time. This happens when your SSDI payment is low enough that you still fall below the SSI income limit. Social Security will pay your SSDI first, then SSI makes up the difference to bring you to the combined federal and state payment level.

MassHealth coverage for people with disabilities

MassHealth is Massachusetts' Medicaid program and covers medical, dental, and mental health services. You do not have to receive SSDI or SSI to get MassHealth; you can may have access to based on disability and income alone. MassHealth has higher income limits than SSI—in 2024, a single person can earn up to about $1,468 per month and still may have access to—and it counts resources differently than SSI does.

There are several MassHealth categories for people with disabilities. MassHealth Standard is for people with disabilities whose income is below the limit. MassHealth CommonHealth allows people with disabilities to work and earn more money while keeping coverage, as long as they pay a small monthly premium based on their income. MassHealth Buy-In is specifically for people who are working and have a disability; it lets you keep MassHealth even if your earnings would normally disqualify you.

If you receive SSDI, you are automatically covered by Medicare after 24 months. Some people have both Medicare and MassHealth; MassHealth then acts as a secondary payer and covers costs Medicare does not pay. This combination is called "dual may be able to access" status and is common in Massachusetts.

The Massachusetts Rehabilitation Commission and work support services

The Massachusetts Rehabilitation Commission (MRC) is a state agency that helps people with disabilities prepare for, find, and keep jobs. MRC services are free and include vocational counseling, skills training, education funding, assistive technology, job coaching, and help with transportation or childcare costs related to work. You do not have to be receiving SSDI or SSI to use MRC; you only need to have a disability that creates a barrier to work.

To work with MRC, you explore at your local MRC office. An MRC counselor will assess your work history, skills, interests, and the barriers you face, then develop a plan with you. If MRC determines that you can work, it will fund the services needed to get you there—this might mean paying for a college degree, a trade certificate, or assistive technology like speech-to-text software. MRC can also pay an employer to hire you on a trial basis or to provide on-the-job training.

MRC services do not affect your SSDI or SSI payments directly, but they can help you earn money while keeping your benefits through Social Security's work incentives. If you are working with MRC and earning wages, you can use the Plan to Achieve Self-Support (PASS) to set aside income and resources for a work goal without losing SSI, or use the Student Earned Income Exclusion if you are under 22 and in school.

Work incentives: How to earn money while keeping benefits

Social Security has several work incentives designed to let you test your ability to work without when ready losing your benefits. The most common is the Trial Work Period, which allows SSDI recipients to work and earn any amount for nine months (not necessarily consecutive) without losing benefits. After the Trial Work Period ends, you enter the Extended may be able to access period, during which you can continue to receive benefits for any month your earnings fall below the substantial gainful activity (SGA) level—in 2024, that is $1,550 per month.

If you receive SSI, the rules are different. SSI has an Impairment Related Work Expenses (IRWE) deduction, which lets you subtract the cost of disability-related work expenses (like attendant care, medication, or medical equipment) from your earnings before SSI calculates your payment. You can also use a Plan to Achieve Self-Support (PASS) to set aside income and resources for a specific work goal—such as starting a business or paying for training—without losing SSI.

MassHealth also has work incentives. If you are on MassHealth and working, you can use MassHealth CommonHealth or MassHealth Buy-In to keep coverage even as your earnings rise. These programs charge a sliding-scale premium based on your income, but they prevent the sudden loss of medical coverage that used to happen when people earned too much.

how the process works for disability programs in Massachusetts

For SSDI and SSI, you explore through the Social Security Administration. You can explore online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. The process asks about your medical condition, your work history (for SSDI), your income and resources (for SSI), and your living situation. You will need to provide medical records, so have your doctors' names and contact information ready.

For MassHealth, you explore through the state. You can explore online at mass.gov/MassHealth, by mail, or in person at a local MassHealth office. The process is separate from the Social Security process, even though both programs look at your income and disability status. Some people are found disabled by Social Security but not by MassHealth, or vice versa, because the programs use different medical standards.

For MRC services, you contact your local MRC office directly. MRC offices are located throughout Massachusetts; you can find yours at mass.gov/MRC. You will meet with a counselor who will determine whether you are may be able to access for services based on your disability and your need for vocational support.

What happens after you are approved

Once you are approved for SSDI, your first payment arrives one month after your approval date. Social Security will send you a notice explaining your payment amount, your Medicare start date (if applicable), and your work incentive options. You are required to report changes in your work status, living situation, or family composition; failure to report can result in overpayments that you will have to repay.

If you are approved for SSI, your first payment also arrives one month after approval. You will receive a MassHealth card automatically if you live in Massachusetts. SSI has stricter reporting requirements than SSDI because it is needs-based; you must report any change in income, resources, living situation, or family status within 10 days.

If you are approved for MassHealth, you will receive a card in the mail within two weeks. You can use it when ready at any provider that accepts MassHealth. If you are also approved for SSDI, your Medicare coverage begins 24 months after your SSDI approval date, not after your MassHealth approval date.

Frequently Asked Questions

Can I receive both SSDI and SSI at the same time in Massachusetts?

Yes. If your SSDI payment is low, Social Security will pay your SSDI first, then add SSI and the Massachusetts state supplement to bring your total payment to the combined limit. This is called "concurrent" receipt. You will receive one payment that combines both programs.

What is the difference between Social Security's definition of disability and MassHealth's?

Social Security uses a strict medical standard: your condition must prevent you from doing any substantial work for at least 12 months or result in death. MassHealth uses a broader standard that includes functional limitations and considers your age, education, and work history. You might be found disabled by one program but not the other.

If I start working, will I lose my benefits when ready?

No. SSDI has a Trial Work Period that lets you work and earn any amount for nine months without losing benefits. SSI allows you to exclude the first $65 of monthly earnings plus half of the remainder. MassHealth has Buy-In and CommonHealth programs that let you keep coverage while working. The key is to report your work to Social Security and MassHealth so they can calculate your benefits correctly.

How long does it take to be approved for disability in Massachusetts?

Initial SSDI and SSI decisions typically take three to six months. If you are denied and appeal, the process can take one to two years. MassHealth decisions are usually faster, often within 30 days. MRC vocational planning can begin when ready after you are found may be able to access, though services themselves may take weeks or months to arrange.

Do I have to use the Massachusetts Rehabilitation Commission if I receive SSDI?

No. MRC services are optional and free. Many people with SSDI never use MRC. However, if you want to work and need help with training, assistive technology, or job placement, MRC can provide those services at no cost to you and will not affect your SSDI payment.