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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
  • Buy-In
  • Family Assistance
  • CarePlus

MassHealth covered services

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:

† 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.

**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

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 (800) 909-2677.

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

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