MassHealth Fee-for-Service

  • Description
  • Funding History
  • Proposals

MassHealth Fee-for-Service covers payments for coverage provided to children and adults through fee-for-service arrangements with providers. Most children are covered by MassHealth Managed Care.

Fee-for-service arrangements pay for certain groups of children or certain services. For example, if children have access to private insurance that is partially subsidized by MassHealth, MassHealth Fee-for-Service will cover the costs of benefits provided under MassHealth Standard that are not provided by the private insurance.

MassHealth Fee-for-Service also covers services for children while a child's initial MassHealth application is undergoing eligibility review.

MassHealth policy changes sometimes result in program and funding shifts among MassHealth line items in the state budget, and children likely account for a very small amount of the costs funded from this line item. Use caution when comparing these line items from year to year.

Updated, February 2018

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