Overview

The Children’s Medical Security Plan provides primary health and dental coverage to uninsured children and adolescents (under age 19). Families contribute through premiums and co-payment, depending on income. Note: Families with income levels up to 400% of the Federal Poverty Guidelines may be eligible for subsidized coverage through ConnectorCare. They also might be eligible for the Health Safety Net (previously known as Free Care) for wrap-around coverage such as inpatient services not covered by CMSP.

Member Booklet   (Large Print version)

• Combined member booklet for MassHealth, the Children’s Medical Security Plan (CMSP), ConnectorCare Plans and Premium Tax Credits, and the Health Safety Net. To get this booklet in Cambodian, Chinese, Haitian Creole, Laotian, Brazilian Portuguese, Russian, Vietnamese, or in Braille please call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648)

Eligibility

To be eligible for the CMSP, an individual must be:

• under nineteen years of age
• a resident of Massachusetts
• not eligible for MassHealth (except MassHealth Limited)
• uninsured

NOTE: MassHealth may limit the number of children who can be enrolled in CMSP. When MassHealth sets such a limit, applicants will be placed on a waiting list.

Premiums

• CMSP members with income up to 300% of the Federal Poverty Level (FPL) no longer have premiums (as of January 2025). 
• CMSP members with incomes greater than 300% FPL will still be charged premiums and continue to be subject to premium billing rules.

Copays

As of January 1, 2025, all Children’s Medical Security Plan (CMSP) members no longer have copays.

The CMSP will pay for services such as:

• primary and preventive health care services (well child visits and immunizations)
• office visits (sick visits and follow-up care)
• urgent care visits not including emergency care in a hospital outpatient or emergency department
• outpatient surgery and anesthesia for tympanostomy (ear) tube placement and for inguinal hernia
• diagnostic laboratory and x-rays
• auditory screenings
• annual and medically necessary eye exams
• dental health care, including preventative dental services, up to $750 per state fiscal year, and provided that no funds be expended for cosmetic dentistry and orthodontic services
• mental health outpatient services including substance abuse services, limited to 20 visits per year
• pharmacy services limited to $200 per state fiscal year
• durable medical equipment, up to $200 per state fiscal year, with an additional $300 per state fiscal year for equipment and supplies related to asthma, diabetes and seizure disorder only

The CMSP will NOT cover:

• emergency room services
• ambulance or other medical transportation
• inpatient hospital care
• cosmetic or orthodontic dentistry

How To Apply

To apply for the CMSP MGH patients should contact Patient Financial Services. Or call: 1-800-841-2900 or visit: Massachusetts Health Connector. Families may also apply at their local community health centers.