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The Children's Medical Security Plan (CMSP) is a health insurance program that provides children and adolescents with access to primary care and preventive services. The Bureau of Family and Community Health in the Department of Public Health contracts with a managed care company to administer the plan.
The Department of Public Health is the state agency responsible for the Children's Medical Security Plan (CMSP) design and for payment of all benefits. Funding for the Plan is provided by the Commonwealth of Massachusetts.
This page provides an overview of CMSP eligibility, cost, and coverage provisions.
Any child age 18 or younger who lives in Massachusetts, is currently uninsured for primary or preventive health care, and is not eligible for primary or preventive health care coverage through MassHealth is eligible for coverage under CMSP.
(MassHealth is a health insurance program run by the state Division of Medical Assistance that pays for health care for qualified people with low and medium incomes.)
The cost of coverage is based on a family's size and household income. For example:
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A family of four earning... |
Pays this monthly amount... |
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$36,800 or less |
No charge |
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$36,801 to $73,600 |
$10.50 per child, up to a family maximum of $31.50 |
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$73,601 or more |
$52.50 per child |
CMSP covers the following services:
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With no copayment |
· well child check-ups · immunizations · family planning services |
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With a $2-$8 copayment (depending on family size and income) |
· office visits when child is sick or hurt · specialty consultations ordered by child's doctor · emergency care up to $1,000 per child per year · lab tests, x-rays, and other diagnostic tests · outpatient mental health care up to 20 visits per year · durable medical equipment up to $200 per child per year, and up to $500 per year for asthma, diabetes, and epilepsy |
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Other |
· Prescription medicines up to $200 per child per year |
All CMSP members receive health cards that they can use at contracting medical providers' offices, community health centers, hospitals, family planning clinics, and pharmacies to receive covered services.
To complete an application over the phone, request an application form (Medical Benefit Request), or for additional information about CMSP, contact the Massachusetts Department of Public Health at 1-800-531-2229.
MA Children's Medical Security Plan (CMSP) - Premiums
MA Children's Medical Security Plan (CMSP) - Services
Information for this topic was drawn from the DPH website at:
http://www.mass.gov/dph/fch/cmsp.htm
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