Chart of MassHealth covered services

This chart shows which services are covered under each of 5 MassHealth coverage types

Use this chart to see which services are covered by each of the following coverage types:

• Standard
• CommonHealth
• Medicare Savings Program (formally MassHealth Senior Buy-In)
• Family Assistance
• CarePlus

MassHealth covered services

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Services	Standard	CommonHealth	Medicare Savings Program**	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:

† This symbol indicates increased service coverage for members 21 years of age and older. The increased coverage was the result of health-care reform legislation effective July 1, 2006.

**Medicare Savings Program 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

For people with MassHealth Limited, MassHealth will pay for the treatment of only certain medical conditions.

The symptoms have to be

• Acute (not a long-term condition)
• So severe that if the member doesn't get medical attention right away, it could result in serious harm to the member's
  • Health
  • Bodily functions, or
  • Organs or other parts of the body.

The Children's Medical Security Plan (CMSP)

The CMSP provides primary and preventive medical and dental coverage to certain uninsured children. These children are not eligible for other MassHealth coverage types except for MassHealth Limited.

CMSP may charge a monthly premium, depending on family income.

Citizenship is not a factor for getting CMSP coverage.

For questions about benefits, covered services, provider network, and other questions about CMSP, contact CMSP Customer Service at [phone].

For questions about eligibility or how to obtain an application, contact a MassHealth Enrollment Center at [phone].