MassHealth Pays For Health Care for Certain Low- and Medium-Income People Living in Massachusetts

Author: Ms. Tyler Moran of MIRA

Albanian and other newcomers to Massachusetts should take advantage of different MassHealth coverage types offered by the Division of Medical Assistance (DMA) for low- and medium-income Massachusetts residents who meet certain eligibility requirements. Listed below are the most comprehensive programs that people are eligible to receive.

  1. MassHealth Standard Coverage: a full range of health care, including hospitals, doctor’s visits, dentists’s visits, lab services, OB/GYN services, well-child visits, prescription drugs, and mental health and substance abuse services. Members: children under 19 and adults 65 years or over, pregnant & people with disabilities, parents & caretakers of children. Some immigrant restrictions apply.
  2. MassHealth Prenatal Coverage: immediate outpatient prenatal care including up to 45 days of routine prenatal office visits and diagnostic tests. Members: low-income pregnant women whose requests for MassHealth Standard coverage are being processed.
  3. MassHealth CommonHealth Coverage: benefits similar to MassHealth Standard. Some members may have to pay premiums or meet a deductible, depending on income. Members: low- and medium-income people with disabilities who are not eligible for MassHealth Standard.
  4. MassHealth Basic Coverage: services are the same as MassHealth Standard excluding long-term care, eyeglasses, hearing aids, and transportation. Members: eligibility requirements: those between the ages of 18- 65 without disabilities or children.
  5. MassHealth Buy-in Coverage: payment of all or part of health insurance premiums only. Members: low-income, long-term unemployed adults who have or can get other health insurance and are not eligible for MassHealth Standard or MassHealth CommonHealth; or some immigrants who cannot get MassHealth Standard because of federal immigration law.
  6. MassHealth Limited Coverage: emergency services including labor and delivery, and “acute medical conditions” that could include prescriptions for 30 days and services provided by doctors and clinics outside the hospital. Members: people who would be eligible for MassHealth Standard but for their immigration status.
  7. Children’s Medical Security Plan (CMSP) provides free or low-cost health care for preventative or primary care for any child, 18 or under, who is ineligible for MassHealth. 8. Healthy Start provides health care for pregnant women who are ineligible for MassHealth.

To learn more about MassHealth and for questions about general eligibility, income and family size, call the MassHealth Enrollment Center (MEC) nearest you listed below:

Charlestown MEC
Tel: 1-800-322-1448

Tewksbury MEC
Tel: 1-800-408-1253

Taunton MEC
Tel: 1-800-242-1340

Springfield MEC
Tel: 1-800-332-5545

 

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