CMSP is for children under the age of 19 who are Massachusetts residents at any income level, who do not qualify for MassHealth (except MassHealth Limited), and who are uninsured. The amount a family pays for CMSP coverage depends on family size and income. There may be a waiting list to receive CMSP coverage.
CMSP covered services include:
- primary and preventive health care services (well child visits and immunizations)
- office visits (sick visits and follow-up care)
- urgent care visits not including emergency care in a hospital outpatient or emergency department
- outpatient surgery and anesthesia for tympanostomy (ear) tube placement and for inguinal hernia
- diagnostic laboratory and x-rays
- auditory screenings
- annual and medically necessary eye exams
- dental health care, including preventative dental services, up to $750 per state fiscal year, and provided that no funds be expended for cosmetic dentistry and orthodontic services
- mental health outpatient services including substance abuse services, limited to 20 visits per year
- pharmacy services limited to $200 per state fiscal year with co-payments of $3 for each generic drug and $4 for each brand name drug
- durable medical equipment, up to $200 per state fiscal year, with an additional $300 per state fiscal year for equipment and supplies related to asthma, diabetes and seizure disorder only
Some examples of services not covered by CMSP
- emergency room services
- ambulance or other medical transportation
- inpatient hospital care
- cosmetic or orthodontic dentistry
Copayments are as follows:
prescriptions - $3 for generic drugs; and $4 for brand name drugs.
Physicians enrolled in MassHealth must be used for services to be covered.
Additional Resources for Physicians
To enroll in MassHealth call MassHealth Customer Service at (800) 841-2900 (TTY (800) 497-4648 for people who are deaf, hard of hearing or speech disabled) to request a Massachusetts Application for Health and Dental Coverage and Help Paying Costs form.
English and Spanish versions of the Massachusetts Application for Health and Dental Coverage and Help Paying Costs form, can be found by using the second link below.
Submit the completed application to:
Health Insurance Processing Center
P.O. Box 4405
Taunton, MA 02780
Additional Resources for Enrollment/application process
MassHealth Customer Service: (800) 841-2900 (TTY (800) 497-4648 for people who are deaf, hard of hearing or speech disabled)
Office Hours: Monday through Friday, 8:00 a.m. to 5:00 p.m.