MassHealth for Children and Young Adults

MassHealth has special rules to make sure children and young adults stay covered.

If you have questions or need help, call us at [phone], TDD/ TTY: 711, or go here to find someone near you who can help.

If you need help understanding your MassHealth coverage, contact My Ombudsman. We offer free support in many languages.

We've got your child covered for at least 12 months!

MassHealth provides 12 months of continuous coverage for members who are under 19 years old.  This means that most children can keep their MassHealth coverage for at least 12 months even if something happens that would normally cause them to lose their coverage (like changes to their family’s income).

After 12 months, members will keep their coverage for as long as they stay eligible.

What’s included in your child’s MassHealth coverage?

MassHealth covers a variety of healthcare services for children and families. Depending on your child’s MassHealth plan, covered services may include the following:

• Well-child screenings (for children under 21), including medical, vision, dental, hearing, mental health and substance use services, developmental screenings, and immunizations (shots)
• Prescriptions
• Outpatient services, like vision care and other services from hospitals, clinics, and doctors
• Behavioral health care
• Reproductive health services, including family planning counseling, birth control, and abortion care (click here to learn more)
• Dental care, including checkups, cleanings, fillings, crowns, and root canals (click here to learn more)
• Free transportation to healthcare appointments for eligible members. Talk to your healthcare provider or click here to learn more.

You might be able to get additional benefits, depending on your child’s coverage. Some members can get help with food, housing, and care management. Call us at [phone], TDD/TTY: 711, to learn more about your MassHealth coverage.

MassHealth coverage for infants

Be sure to tell MassHealth after you have your baby. You can do this a few ways:

1. Have the hospital fill out a notice of birth (NOB) form. You can ask your healthcare provider about your hospital’s process for doing this. Contact MassHealth to make sure that your baby has been enrolled with the correct birth date and information.
2. Call the MassHealth Customer Service Center at [phone], TDD/TTY: 711. Representatives are available Monday through Friday 8:00 a.m. through 5:00 p.m. Interpreter service is available.
3. Report the birth in our member portal.

Your baby will be covered by MassHealth for at least 12 months starting the day they’re born.

To enroll your baby in a health plan and choose a pediatrician, call us at [phone], TDD/TTY: 711. You can also visit masshealthchoices.com.

Behavioral health resources (mental health and substance use) 

• The Behavioral Health Help Line is available 24/7 for all Massachusetts residents. Call or text [phone] or visit the website to chat.
• Community Behavioral Health Centers (CBHCs) offer immediate help 24/7 for a wide range of mental health and substance use disorder treatment programs. CBHCs also have mobile crisis teams that can come to your home, school, or other location 24/7. To find a CBHC near you, click here.
• Children's Behavioral Health Initiative (CBHI) helps MassHealth children and their families with behavioral, emotional, and mental health needs. It provides services like in-home therapy, in-home behavioral support, therapeutic mentoring, family support and training, and intensive care coordination. For support in accessing CBHI service providers, please contact your child’s MassHealth plan.
• MassHealth covers applied behavior analysis (ABA), a service that helps children who have autism spectrum disorder, and their families, increase skills such as language, communication, social skills, and positive behaviors useful for daily activities. For help finding ABA providers, please contact your child’s MassHealth plan.
• The Massachusetts Substance Use Helpline can answer your questions, listen to your concerns, and refer you to special treatment and recovery support services for youth and young adults. Talk to a helpline specialist by calling [phone] or using the chat on the helpline’s web page. 

Talk to your or your child’s healthcare provider about other behavioral health and substance use disorder resources.

Additional resources for children and families

There are many resources available to support eligible individuals and families with housing, nutrition, financial assistance, and other needs, including:

• The Women, Infants & Children Nutrition Program (WIC) is a nutrition program for eligible Massachusetts families. WIC provides free healthy foods, breastfeeding support, and referrals to healthcare and other services to eligible Massachusetts families. Most pregnant MassHealth members qualify for WIC. For more information and to apply, click here.
• The Massachusetts Department of Transitional Assistance (DTA) helps low-income people and families meet their basic needs and improve their quality of life. DTA gives one in seven Massachusetts residents direct economic help (cash benefits) and food help (SNAP benefits). DTA also helps with job training opportunities. For more information and to apply, click here.
• Family Resource Centers are a statewide network of community-based providers offering multicultural parenting programs, support groups, early childhood services, and education for families with kids up to 18 years old.
• Family Caregiver Support Program This free program can help you care for a member of your family. A caregiver specialist will create a plan and give you tips and support.
• Massachusetts Early Intervention is a free statewide program for infants and toddlers (birth to 3 years old) who have, or are at risk of, developmental delays.
• The Massachusetts Department of Public Health offers several free, voluntary, and confidential home visiting programs for eligible families expecting a child, or eligible families with young children, in some communities.
  • The Early Intervention Parenting Partnerships (EIPP) Program supports families from pregnancy through a child’s first birthday.
  • FIRST (Families In Recovery SupporT) Steps Together provides recovery and parenting support to people who are affected by current or past substance use and have at least one child age 5 or under. You don’t need to live with your children to qualify. Services are provided by specially trained staff members who are parents in recovery, as well as by mental health counselors who are trained in addiction and parenting.
  • F.O.R. Families (Follow-Up Outreach Referral) helps families transition from emergency assistance shelters to stable housing.
  • Welcome Family offers caregivers a one-time 90-minute home visit from a nurse, up to 8 weeks after a child is born.

Other programs and services

School-based health centers

School-based health centers (SBHCs) provide healthcare to students in a school building. There are 41 health centers in 22 Massachusetts cities and towns, mostly in high schools. Services may include mental health care, reproductive health care, access to social services, oral health care, and health education. 

Resources for children with special health needs or disabilities

• Family Together in Enhancing Support (TIES) of Massachusetts provides information and referral services (including a resource guide), emotional support, and training to parents of children and young adults with special needs.   
• DPH’s Community Support Line for Children and Youth with Special Health Needs, at [phone], provides information and resources for families of children and young adults with special health needs. It’s offered by the Division for Children & Youth with Special Health Needs.
• The Pediatric Palliative Care Network (PPCN) is managed by the Massachusetts Department of Public Health (DPH) and supports people younger than 22 and who have a life-limiting diagnosis, and their families.
• The Children’s Autism Waiver Service Program from the Massachusetts Department of Developmental Services provides service and support for children ages 0–9 who have autism spectrum disorder and meet certain requirements.
• Special Kids Special Care is a medical care management program for children in the custody of the Massachusetts Department of Children and Families who get complex medical care on a regular basis.
• Continuous skilled nursing (CSN) services may be available through the Community Case Management (CCM) Program, managed by the University of Massachusetts Medical School. Members who qualify for more than two continuous hours a day of in-home nursing services may qualify for these services. Call the CCM Program at [phone] or email [e-mail].
• Complex care assistant (CCA) services are a MassHealth personal care service provided by continuous skilled nursing (CSN) agencies, or certain people hired by CSN agencies, to members who need CSN services. These people could include a legal guardian, parent, spouse, or other family member. CCA services do not replace CSN services. CCAs may perform personal care tasks like feeding, dressing, toileting, and personal hygiene, as well as other enhanced care tasks like enteral feedings (a way of feeding through a tube), oxygen therapy (a way of providing extra oxygen to people with breathing problems), and oral suctioning (a way of removing excess mucus or saliva). You can find more information on this service here.
• Therapy services may be available to MassHealth members who meet certain criteria. They include physical, occupational, and speech/language therapy. A member may receive these services even if they are already receiving therapy services in school.
• Durable medical equipment, prosthetics, orthotics, and oxygen and respiratory (DMEPOS) supplies may be available to MassHealth members who meet certain criteria. They include many types of durable medical equipment, oxygen and respiratory supplies, orthotics, and prosthetics (for example, knee braces and artificial limbs).
• The MassHealth Personal Care Attendant (PCA) Program helps people who have permanent or chronic disabilities keep their independence and manage their own personal care by helping them pay for PCAs. If you’d like more information about the PCA Program or want to enroll for services, please contact a personal care management (PCM) agency in your area. You can find a PCM agency here.
  • If a child has special healthcare needs that require PCA services, the child’s legal guardian is responsible for recruiting; hiring; scheduling; training; and, if necessary, firing PCAs.

MassHealth Coordinating Aligned, Relationship-centered, Enhanced Support (CARES) for Kids Program Services

This program helps eligible members younger than 21 who have complex medical and social needs, and their families, to plan and coordinate care across the health, educational, state agency, and social service systems. You can find more information about CARES for Kids providers here.

For more information on all services and programs available for children and young adults with special health needs, please visit the Services for Children and Youth with Special Health Needs web page.

Date published:	December 6, 2024