WHAT IS THE CHILDREN'S MEDICAL SECURITY PLAN?
Despite the MassHealth expansion, an estimated 50,000 children will remain uninsured in Massachusetts. For families up to 400% poverty level, or $53,320/year (in 1998) for a family of three, the Massachusetts Children’s Medical Security Plan offers children limited outpatient benefits for modest co-payments.
CMSP is ideal for families whose employers do not offer health insurance or people who are self-employed or work part-time. Also, individuals who have access to health insurance through their work, but cannot afford the premium contributions, deductibles or co-payments may apply.
CMSP offers well-child check-ups, immunizations, and smoking prevention information and materials for parents and children without having to make co-payments. For $1-5 co-payments (depending on family size and income) CMSP offers sick visits, hearing tests, diagnostic tests, limited emergency care, limited outpatient mental health, specialty consultations ordered by a doctor, outpatient surgery for inguinal hernia or inserting ear tubes, and some durable medical equipment such as inhalers. For $3 (generic) and $4 (brand name) copayments, children may receive up to $100 in prescription drugs per year. Legislation has been passed that will add dental care benefits, vision screenings and expand mental health care in the near future.
Note that inpatient services are not covered by CMSP. Free care or MassHealth Limited may fill this gap in care. Also, the child’s pediatrician must be enrolled in CMSP. If the child’s current pediatrician is not participating in the program, the family has to change providers.
Until the new MassHealth application arrives, parents must fill out the CMSP application. Call 1-800-909-CMSP (2677) for an application and information.
The previous article was compiled from "Newsline: from the Federation for Children with Special Needs", Fall 1997 and the CMSP information pamphlet. Edith Kenneally of Patient Financial Services contributed many policy updates.
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