Long-Term Care Community Services is a consumer-directed program for MassHealth members who are chronically disabled and require physical assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Personal Care Management services are provided by 23 Personal Care Management agencies that contract with MassHealth (9 of these agencies are ASAPs - Aging Services Access Points). Four intermediaries, providing services such as payroll functions, if delegated by the member, provide fiscal management services.

Early Intervention (for children age 3 or younger) is a program certified by the Department of Public Health to provide social, medical, education, therapeutic, and developmental services for children age 3 or younger who are at biological, environmental or established risk, and their families.

The Hospice benefit is available to terminally ill MassHealth members who are living in the community or in a nursing facility. For those who elect to receive this service, it is an all inclusive benefit that includes nursing, physician assistance, counseling services, homemaker/home health aide, physical therapy, occupational therapy, speech/language therapy, and drug and durable medical equipment services.

Private Duty Nursing enables MassHealth members living in the community to receive care from a nurse in their home. It requires a visit of more than two hours. Both home health agencies and independent nurses provide this service. Please note: this benefit is under re-design.

Home Health Agency services are provided to MassHealth members who are homebound and require a skilled nursing or skilled therapy service. Services include: nursing, how health aide, personal care worker, physical therapy, occupational therapy, and speech/language therapy. All home health services must be furnished under a plan of care established individually for the member by the member's physician.

Therapies provided by independent practitioners to recipients include a provision of physical, occupational, and speech.

The Durable Medical Equipment Program (DME) facilitates and manages the reimbursement of the purchase, rental, and/or repair of durable medical equipment and the purchase of medical and surgical supplies. All durable medical equipment and medical/surgical supplies must be of proven quality and dependability and conform to all applicable federal and state product standards. Durable Medical Equipment includes the Personal Emergency Response System (PERS).

Oxygen & Respiratory, Orthotics, and Prosthetics services include oxygen devices, respiratory equipment and supplies. Braces, shoes, and splints are included under prosthetics. Coverage for children is more expansive than for adults over age 21. Prosthetics includes devices to replace limbs (upper and lower). Coverage for children is more expansive than for adults over age 21.

Rehabilitation Clinics provide comprehensive services deemed appropriate to the needs of individuals requiring therapy.

Speech and Hearing Clinic centers provide evaluation and treatment for speech, language, voice, and fluency disorders.

To learn about MassHealth benefits, contact the MassHealth Customer Service Center:

1-800-841-2900
(TTY: 1-800-497-4648 for people with partial or total hearing loss)