How to apply for Health Safety Net (Hospital & Health Center Care)

Who it's for

The Health Safety Net pays acute-care hospitals and community health centers for care to uninsured and underinsured Massachusetts residents. Residents with income up to 150% of the poverty level get services with no deductible; from above 150% up to 300% FPL ($3,990 a month for one person in 2026), a deductible applies. It also fills gaps for people with Medicare or private insurance, and Medicare Savings Program members are enrolled automatically. Seniors are screened through the same SACA-2 application as MassHealth. It works only at hospitals and community health centers — it is not insurance.

What you'll need

• ACA-1 or SACA-2 application (seniors 65+ use the SACA-2)
• Proof of identity, Massachusetts residency, and income
• Annual renewal

Where to apply

What to say when you call

“Hello, I'm calling to ask about Health Safety Net (Hospital & Health Center Care). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need aca-1 or saca-2 application (seniors 65+ use the saca-2), proof of identity, massachusetts residency, and income, annual renewal — is anything else required? What is the best next step?”

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Gather your documents before you start. You will need proof of identity, proof of Massachusetts residency, and proof of income.
2. Get the right application form. Seniors age 65 and older use the SACA-2 form, which also screens for MassHealth at the same time.
3. Apply online through the Massachusetts Health Connector or call MassHealth at 1-800-841-2900 to apply by phone or request help.
4. Submit your completed SACA-2 along with all required proof documents through your chosen application method.
5. Watch for a notice about your eligibility and any deductible that may apply based on your income level.
6. Renew your coverage every year. MassHealth will contact you when it is time to renew — respond promptly to avoid a gap in coverage.

What to expect: After you submit your application, MassHealth reviews your documents and determines whether you qualify for the Health Safety Net. Processing times vary, so ask MassHealth for an estimate when you apply. If approved, you can use the benefit at acute-care hospitals and community health centers in Massachusetts — it is not insurance and does not work at other provider types. If your income is above 150% of the federal poverty level but at or below 300%, a deductible will apply before the Health Safety Net pays for your care. If you already have Medicare or private insurance, the Health Safety Net can help fill coverage gaps. Renewal is required every year; respond to any renewal notices from MassHealth right away to keep your coverage active.

Renewals

annual