With the availability of Title XXI funding, the state further expands coverage through both a Medicaid expansion and a separate Title XXI insurance program, MassHealth Family Assistance Plan. In addition, the state provides premium payments to help families purchase employer-sponsored coverage. Presumptive eligibility is offered to children for up to 60 days. This will cover medical services needed while the MassHealth application is being processed. No children receive a guaranteed duration of eligibility.
Eligibility is subject to periodic review.
Pregnant women who are determined eligible for MassHealth Standard continue to be eligible for the duration of pregnancy and the two calendar months following the month in which their pregnancy ends. Individuals not yet enrolled in a managed care plan may receive services from any MassHealth provider on a fee for service basis. Coverage is based on Federal Employee Health Benefits Package. It provides the same benefits as MassHealth Standard with the exception of long term care, day habilitation, private duty nursing, and non-emergency transportation. Whether or not an applicant has, or has access to, employer-sponsored insurance is assessed during the presumptive eligibility period.