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Basic Needs

Health Care Coverage
Kids/Parents
(see also: MassHealth)

Most children should have access to some type of health care coverage in Massachusetts. Low income pregnant women may also qualify for MassHealth at higher income levels than other adults, and even if undocumented.

Click on the links below to jump to each section:

  • Children's Medical Security Plan
  • MassHealth Standard for Pregnant Women
  • Catastrophic Illness in Children Relief Fund
  • DPH Pediatric Palliative Care Program
  • Additional Resources
    • MassHealth
    • Health Safety Net
    • ConnectorCare
  • Immigrant Children
  • Also see:  Young Adults - See Young Adult Coverage page

  • Children's Medical Security Plan (CMSP)

    The CMSP provides healthcare coverage for children under age nineteen who live in Massachusetts and are not eligible for MassHealth or MassHealth CommonHealth. The CMSP offers limited, primarily well-child and preventative care, coverage. It covers routine check-ups, immunizations, dental care and smoking prevention materials with no co-pay.

    More information:

    Children's Medical Security Plan


    MassHealth Standard for Pregnant Women

    Pregnant women with income up to 200% FPL are eligible for full MassHealth Standard regardless of immigration status (i.e., undocumented are eligible). Eligibility for postpartum care continues for 60 days following the termination of the pregnancy plus an additional period extending to the end of the month in which the 60-day period ends.).

    Note: As part of Affordable Care Act implementation, Healthy Start the former program for pregnant women who were ineligible for MassHealth, generally due to immigration status, has been eliminated as these women are now eligible for MassHealth Standard. Healthy Start only offered pregnancy-related coverage rather than full MassHealth Standard benefits now available during pregnancy.


    Catastrophic Illness in Children Relief Fund (CICRF)

    The CICRF provides financial assistance as a last resort payor for excessive expenses incurred by children and their families for services for special healthcare needs that are not covered by other healthcare coverage or financial programs. CICRF is a reimbursement fund; the services must have already been provided.

    Typical requests include:

    • home modifications
    • special vehicle purchases
    • transportation

    Eligibility criteria include:
    • no healthcare coverage or coverage that will not pay the services;
    • child up to age 21
    • MA resident (no citizenship requirement).

    Eligibility is based on the child’s medically related expenses compared to family income- medically related expenses must exceed 10% of annual family income up to $100,000 plus 15% of annual family income in excess of $100,000.

More Information:

Massachusetts CICRF


DPH Pediatric Palliative Care Program

The PPC program helps to meet the needs of eligible children with life-limiting illnesses and their families or guardians by providing services designed to achieve an improved quality of life by meeting the physical, emotional and spiritual needs experienced during the course of illness, death and bereavement.

More Information:

"New DPH Pediatric Palliative Care Program" - MGH Community News, January 2007


Additional Resources

MassHealth

Health Safety Net (HSN- formerly Free Care)

ConnectorCare

    Parents may be able to purchase health insurance through The Connector (the state's insurance exchange). Those with incomes up to 300% FPL may be eligible for state and federal subsidies; and those with incomes up to 400% FPL may be eligible for federal subsidies alone.

 


Immigrant Children

See MassHealth Eligibility - Immigrant Children

 

Rev 7/17