Learn about MassHealth coverage types for individuals, families, and people with disabilities

Are you an individual, family, or person with a disability? Learn about MassHealth coverage types.

This section describes the six MassHealth coverage types offered to eligible individuals, families, and people with disabilities:  Standard, CommonHealth, CarePlus, Family Assistance, Premium Assistance, and Limited. To apply for coverage, complete a Massachusetts Application for Health and Dental Coverage and Help Paying Costs (ACA-3). MassHealth will determine which program or MassHealth coverage type you can get. MassHealth will give you the most complete coverage that you can get. Your eligibility depends on things like income, citizenship or immigration status, age, and special circumstances. You must be a Massachusetts resident to get any of these services. 

MassHealth Standard

MassHealth Standard provides a full range of health care benefits.

Covered services

For MassHealth Standard, covered services include the ones listed below. There may be some limits.

  • Inpatient hospital services
  • Outpatient services: hospitals, clinics, doctors, dentists, family planning, vision care
  • Medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, medical equipment and supplies
  • Adult day health and adult foster care
  • Mental health and addiction services:  inpatient and outpatient
  • Well-child screenings (for children under 21), including: medical, vision, dental, hearing, mental health and addiction services, developmental screens, shots
  • Long-term services and supports at home or in a long-term-care facility, including home health services
  • Transportation services
  • Services to help you quit smoking

Note:  For disabled adults who also get Medicare Part B, MassHealth will pay the Medicare premium and, if applicable, the coinsurance and deductibles.

Important information for children and youth with significant mental health needs or serious emotional disturbance (SED)

MassHealth offers certain behavioral health services for eligible children and youth under 21 who are enrolled in MassHealth Standard or MassHealth CommonHealth. If your child is not eligible for MassHealth Standard and a behavioral health evaluation shows that your child has significant mental health needs or a serious emotional disturbance, your child may be eligible for MassHealth CommonHealth.

More services for those under 21

Children, teens, and young adults under 21 who are eligible for MassHealth Standard are also eligible for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services. This includes all medically necessary services covered under the law. You may have copayments for some services.

MassHealth CommonHealth

MassHealth CommonHealth offers health care benefits similar to MassHealth Standard to certain disabled adults and disabled children who cannot get MassHealth Standard.

Covered services

For MassHealth CommonHealth, covered services include the ones listed below. There may be some limits. 

  • Inpatient hospital services
  • Outpatient services: hospitals, clinics, doctors, dentists, family planning, vision care
  • Medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, medical equipment and supplies
  • Adult day health and adult foster care
  • Mental health and addiction services
  • Well-child screenings (for children under 21): medical, vision, dental, hearing, mental health and addiction services, developmental screens, shots
  • Long-term services and supports at home or in a long-term-care facility, including home health services
  • Transportation services
  • Services to help you quit smoking

Important information for children and youth with significant mental health needs or serious emotional disturbance (SED)

MassHealth offers certain behavioral health services for eligible children and youth under 21 who are enrolled in MassHealth Standard or MassHealth CommonHealth. If your child is not eligible for MassHealth Standard and a behavioral health evaluation shows that your child has significant mental health needs or a serious emotional disturbance, your child may be eligible for MassHealth CommonHealth.

More services for those under 21

Children, teens, and young adults under 21 who are eligible for MassHealth CommonHealth are also eligible for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services. This includes all medically necessary services covered under the law. You may have copayments for some services. 

MassHealth CarePlus

MassHealth CarePlus offers a broad range of health care benefits to adults who are not otherwise eligible for MassHealth Standard.

Covered services

For MassHealth CarePlus, covered services include the ones listed below. There may be some limits. 

  • Inpatient hospital services
  • Outpatient services: hospitals, clinics, doctors, dentists, family planning, vision care
  • Medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, medical equipment and supplies
  • Mental health and addiction services
  • Home health services
  • Transportation services
  • Services to help you quit smoking

Individuals who are medically frail

If you are medically frail, you may be able to get MassHealth Standard, which gives you more benefits. You are medically frail if:

  • You have a medical, mental health, or addiction condition that limits your ability to work or go to school
  • You need help with daily activities, like bathing or dressing
  • You get regular medical care, personal care, or health services at home or in another community setting, like adult day care
  • You are terminally ill

If you move to MassHealth Standard, there may be some more steps needed to get some of the added benefits that MassHealth Standard gives. For example, MassHealth may need more information or may need to make sure the benefits are necessary and right for you. Your doctor and MassHealth Customer Service can help explain these extra steps to you.

MassHealth Family Assistance

You may get MassHealth Family Assistance if you are a Massachusetts resident and are not eligible for MassHealth Standard.

Covered services

For MassHealth Family Assistance, covered services include the ones listed below. There may be some limits. 

  • Inpatient hospital services
  • Outpatient services: hospitals, clinics, doctors, dentists, family planning. vision care
  • Medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, medical equipment and supplies
  • Home health services
  • Mental health and addiction services
  • Developmental screens
  • Shots
  • Ambulance services (emergency only)
  • Services to help you quit smoking

Premium Assistance

If you have, or have access to, other health insurance, MassHealth may pay all or part of your household's health insurance premiums. For more information, see Other health insurance and MassHealth Premium Assistance.

MassHealth Limited

MassHealth Limited provides emergency health services to people who have an immigration status that keeps them from getting more services.

Covered services

For MassHealth Limited, covered services include the ones listed below. You can get care only for medical emergencies (conditions that could cause serious harm if not treated). There may be some limits.

  • Inpatient hospital emergency services, including labor and delivery
  • Outpatient hospital emergency services and emergency visits to emergency rooms
  • Certain medical services provided by doctors and clinics outside of a hospital
  • Pharmacy services for treating an emergency medical condition
  • Ambulance transportation for an emergency medical condition only

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