girl at beach boy with dad family family
Member Information
Provider Information
Provider Search
link to home page link to about us page link to MassHealth home page


CMSP Premium and Co-pay Information

MassHealth determines your Federal Poverty Level (FPL) with the income information provided on your application.  Below are the FPLs used to determine your premiums and co-payment amounts.  If you think you fall into a different FPL than the one you are now in, please update your income with the MassHealth Customer Service at 1-800-841-2900.

    CMSP
    Premium and Copayment Chart

    Monthly Premiums

0-199.9% FPL
200.0-300.9% FPL
301.0-400.0%FPL 400.1% and above FPL

$0

$7.80 per child/max $23.40 per family

$33.14 per family

$64 per child


Copayments*
Medical (non-preventive)
$2
$5
$5
$8
Dental
$2
$4
$4
$6
Pharmacy

$3 for each generic drug, $4 for each brand name drug


*Only one copay is required per day for medical visits.

This chart is provided as a guide only as more factors are used to determine your premium amount each month. If you have questions about your CMSP premiums, contact MassHealth Customer Service at 1-800-841-2900.

© 2007 UniCare Life & Health Insurance Company | Legal Notice