Services

Standard

CommonHealth

Buy-In**

Family Assistance***

CarePlus

Abortion

 

Acute inpatient hospital

 

Adult day health

 

 

 

Adult foster care

 

 

 

Ambulatory prenatal care

 

Ambulatory surgery center services

 

 

Audiologist/hearing services

 

Behavioral health (mental health and substance use disorder) services

 

Chiropractor

 

Chronic disease and rehabilitation inpatient hospital

 

Community health center

 

Continuous skilled nursing

 •

 

 

 

Day habilitation

 

 

 

Dental services

 

Dialysis services

 

Durable medical equipment (includes oxygen and respiratory therapy equipment)

 

Early intervention

 

 

Early and periodic screening, diagnosis and treatment (EPSDT) services

 

 

 
Emergency Inpatient and Outpatient Hospital Services 

Family planning

 

Group adult foster care services

 

 

 

Hearing aid and dispensing services

 

Home health

 

Hospice

 

Intensive Early Intervention  

Laboratory

 

Medicare Part B premium

 

 

 

 

Medical/surgical supplies

 

Nursing facility services

 

 

Nurse midwife

 

Nurse practitioner

 

Orthotic

 

Outpatient hospital

 

Personal care

 

 

 

Pharmacy

 

Physician

 

Podiatrist

 

Preventive pediatric healthcare screening and diagnostic (PPHSD) services

 

 

 

 

Prosthetic

 

Radiology and diagnostic services

 

Therapy (physical, occupational, and speech/language)

 

Transportation (emergency)

 

Transportation (non-emergency)   

Vision care (exams/treatment)

 

Vision care (ophthalmic materials)

 

Please Note:

Text marked with this symbol indicates increased service coverage for members aged 21 years and older as a result of health-care reform legislation effective July 1, 2006.

**MassHealth Senior Buy-In also covers Medicare Part A Premium and Medicare Parts A and B coinsurance and deductibles, where applicable.

***Persons in Family Assistance with HIV will receive coverage for all medically necessary services, including the expansion of chiropractor, dental, vision, orthotic, prosthetic, and tobacco-cessation services.

 

MassHealth Limited Coverage:

MassHealth pays only for the treatment of a medical condition (including labor and delivery) that manifests itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in:

  • placing the member's health in serious jeopardy;
  • serious impairment to bodily functions; or
  • serious dysfunction of any bodily organ or part.

 

The Children's Medical Security Plan (CMSP):

The CMSP provides primary and preventive medical and dental coverage to certain uninsured children who are not eligible for other MassHealth coverage types, except MassHealth Limited. CMSP may charge a monthly premium, depending on family income. Citizenship is not a factor in the eligibility determination for CMSP.

For questions about benefits, covered services, provider network, and other inquiries about CMSP, contact CMSP Customer Service at 1-800-909-2677.

For questions about eligibility or how to obtain an application, contact a MassHealth Enrollment Center at 1-888-665-9993.

 


This information is provided by MassHealth.