Children's Medical Security Plan
Official Title: Children's Medical Security Plan
- Funding History
The Children's Medical Security Plan (CMSP) provides primary and preventive services for uninsured children through age 18 who are not eligible for MassHealth.
The program covers any child who is a resident of Massachusetts at any income level who is not eligible for MassHealth (with the exception of MassHealth Limited), and who does not have physician or hospital health care coverage.
CMSP was created in the early 1990s to serve uninsured children, before the state expanded MassHealth coverage for children, and now is an important source of health care coverage for children who do not meet the citizenship or immigration status requirements for MassHealth. The program is administered by UniCare Life and Health Insurance Company.
The program covers services that are frequently needed by children. These selected services include outpatient doctor visits, including preventive care, eye exams and hearing tests, as well as a limited number of outpatient mental health and substance abuse treatment visits, a limited amount of prescription drug coverage, and a limited amount of dental services. CMSP does not, however, cover hospitalization, emergency room visits, or ambulance services. Premiums and co-payments for the program are based on a sliding scale.
Coverage is also strictly limited by specific caps on individual services. For example, there is an annual $200 limit on coverage for prescription drugs, a $200 annual limit on durable medical equipment, and a 20 visit annual limit on outpatient behavioral health visits. Massachusetts may also place an enrollment cap on the program.
Updated, March 2015
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