State programs provide access to health care.
Massachusetts state law dictates that adults in the state must carry health insurance if their budgets allow. Those found to lack insurance while being able to afford it may be fined. Massachusetts health care options include several health insurance assistance programs that cover a wide range of low-income individuals. Numerous group-specific programs exist, including the Student Health Insurance Program (SHIP) and Senior Care Options (SCO).
MassHealth
Massachusetts residents earning a low to medium income may apply for MassHealth public insurance. Though individual services vary depending on the program type selected, typical benefits include dental, home health, mental health and appointment transportation services.
Eight general programs exist. Low-income parents of children below age 19, the elderly and the disabled may apply for complete health coverage through MassHealth Standard. Those who earn too much for Standard may qualify for CommonHealth. Family Assistance is for children and HIV patients. MassHealth Basic covers unemployed mentally ill patients receiving treatment through the Department of Mental Health. Individuals receiving aid through the state's Emergency Aid to Elders, Disabled, and Children (EAEDC) program may also qualify for Basic.
MassHealth Limited offers emergency coverage for non-citizen immigrants. MassHealth Prenatal offers limited care for pregnant low-income women. The Medicare Buy-In program helps cover any monthly payments required for Medicare coverage. Finally, MassHealth Essential offers basic, limited coverage to the long-term unemployed.
Commonwealth Care
Commonwealth Care covers low- to medium-income residents who do not qualify for other state programs such as MassHealth. The coverage plans come from private insurance with little to no cost.
Cost is determined by the individual's (or family's) income and how it compares to the Federal Poverty Guidelines (FPG). Those who earn 100 percent or less of the FPG do not have monthly payments. Paid coverage is available for those up to 300 percent of the FPG. Those earning more may be eligible for Commonwealth Choice, a similar paid-coverage plan.
Commonwealth Care covers outpatient and inpatient medical care, mental health care, prescription drugs and limited-vision care. Only those below the 100 percent FPG receive dental care.
Health Safety Net Fund
The Health Safety Net Fund exists to provide coverage to those who are underinsured or uninsured, regardless of income. The Fund also helps pay off high medical bills that an individual or family can't cover. There is no charge for the Safety Net.
Safety Net coverage extends only to treatment received at hospitals and state community health centers. There's also a list of services that details what the Safety Net will cover.
Children's Medical Security Plan
The Children's Medical Security Plan covers children below the age of 19 who lack insurance and do not qualify for MassHealth. CMSP is not dependent on income, but those who are not low-income may have to pay a monthly fee.
CMSP covers outpatient treatment, dental care, prescriptions, and family planning. Inpatient hospital care is not covered.
Prescription Advantage
Elderly or disabled individuals may qualify for Prescription Advantage. This plan assists in paying the costs associated with Medicare Part D prescription coverage. The plan also covers prescription costs for those not on Medicare. Individuals usually need to pay a monthly premium for this service.
Tags: Commonwealth Care, health care, Care covers, Care Options, children below, Children Medical, Children Medical Security
