Chart of MassHealth Covered Services

Services	Standard	Basic*	CommonHealth	Essential*	Buy-In**	Prenatal	Family Assistance***
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 abuse)	•	•	•	•			•
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	•		•
Family planning	•	•	•	•			•
Group adult foster care services	•		•
Hearing aid and dispensing services	•	•	•				•
Home health	•	•	•				•
Hospice	•		•				•
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	•	•	•				•
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 Basic and Essential coverage types require managed care enrollment before application of benefits.

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

Prenatal services are covered if directly related to the pregnancy, and are valid only for up to 60 days. Labor and delivery are not covered services.

***Persons 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.

Healthy Start Program (HSP):

This program provides coverage for medically necessary pregnancy-related services to low-income, uninsured pregnant women who are not eligible for other MassHealth benefits except MassHealth Limited. Women eligible for Healthy Start are also eligible for MassHealth Limited, which covers emergency services, including labor and delivery. No premium is charged to members of this program.

For questions about benefits, covered services, provider network, and other inquiries about the HSP, contact HSP Customer Service at 1-888-488-9161.

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 a Medical Benefit Request (MBR), contact a MassHealth Enrollment Center at 1-888-665-9993.

This information is provided by MassHealth.

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Chart of MassHealth Covered Services

Please Note:

MassHealth Limited Coverage:

Healthy Start Program (HSP):

The Children's Medical Security Plan (CMSP):

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Chart of MassHealth Covered Services

Please Note:

MassHealth Limited Coverage:

Healthy Start Program (HSP):

The Children's Medical Security Plan (CMSP):

Complementary Content