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AFFORDABLE HEALTH INSURANCE FOR YOUR CHILDREN
No child should go without the medical or dental care they need. The Children's Medical
Security Plan is a program offered by MassHealth which
provides the basic medical and dental coverage that kids need most. Call 1-888-665-9993
if you would like to know how to enroll in the Children's Medical Security Plan.
All children under the age of 19 who are not eligible for MassHealth or not accessing
comparable primary and preventive health care insurance may enroll. The amounts you pay
for coverage depend upon your total family size and income and may even be free.
CMSP covers the following medically necessary medical, behavioral, dental, and pharmacy services:
Medical and Behavioral Health Services
- Copayments are $2, $5, or $8, depending on household income (see FPL chart), for non-preventive medical visits and all mental health visits; one copayment per day
- Outpatient office visits including preventive health care visits
- Durable medical equipment up to $200 maximum per state fiscal year (July 1-June 30), with an additional $300 per fiscal year for equipment and supplies related to asthma, diabetes, and seizure disorders only
- Mental health services and substance abuse treatment up to 20 visits per state fiscal year
- Surgical procedures, which are limited to insertion and removal of tympanostomy ear tubes, including anesthesia (outpatient only) and repair of inguinal hernia, including anesthesia (outpatient only)
Dental
- Maximum dental benefit is $750 per state fiscal year (July 1-June 30)
- Copayments are $2, $4, or $6, depending on household income (see FPL chart), for all covered dental care, one copayment per day
- Dental exams and cleanings (limited to twice per fiscal year)
- Xrays (Full-mouth series limited to 14 films once every 36 months; bitewing films limited to once per fiscal year)
- Fluoride treatment (limited to twice per fiscal year)
- Sealants (limited to once per fiscal year)
- Fillings
- Simple extractions
- Full or partial root canals
- Crowns on primary teeth
- Space maintainers used in place of prematurely lost teeth
Pharmacy
- Prescription drugs up to $200 per state fiscal year (July 1-June 30)
- Copayments are $3 for each generic drug and $4 for each brand-name drug
- Prescriptions are administered through Wellpoint Pharmacy ProServ . Pharmacists - Please use group 06294, the member's ID number listed, Rx Bin Number 610053, and a patient relationship code of 03.
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