How Frequently Does Mass Health Cover Physicals?

by | Last updated on January 24, 2024

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MassHealth pays for many important health-care services including

doctor visits, hospital stays, rehabilitation and therapeutic services, and behavioral health and substance use disorder services

. To get more specific information, call the MassHealth Customer Service Center.

What limited MassHealth covers?

MassHealth Limited covers

only care for medical emergencies

(conditions that could cause serious harm if not treated).

What is the maximum income to qualify for MassHealth?

Household Size* Maximum Income Level (Per Year)
1


$18,075

2


$24,353

3


$30,630

4


$36,908

How do I check my MassHealth coverage?

If you are a MassHealth, Commonwealth Care, or Health Safety Net member or applicant you can get the same information

by phone at (888) 665-9993

. When you call this number, select a language and then press Option 1. You will be led through a series of easy menus to access your information.

Does MassHealth cover gym membership?


Eligible Tufts Health Together (MassHealth) members can receive a reimbursement of up to $30 once every calendar year for a gym membership or fitness-related activity

.

Does MassHealth cover genetic testing?


MassHealth covers BRCA1 and BRCA2 genetic testing for susceptibility to breast or ovarian cancer in adults as medically necessary with single-site analysis for the known familial variant

(Current Procedural Terminology [CPT]® codes 81215, 81217) for a biologically related individual from a family with a known BRCA1 or …

Does MassHealth cover vasectomy?


Masshealth (Medicaid) and other state programs also cover vasectomy

. Generally, a vasectomy costs between 300USD & 3,000USD.

Does MassHealth cover skin removal surgery?


MassHealth considers approval for coverage of excision of excessive skin and subcutaneous tissue on an individual, case-by-case basis

, in accordance with 130 CMR 409.000 and 130 CMR 450.204. c. the member has achieved a 50% or greater excess body weight loss (%EBWL) or excess body mass index loss (% EBMIL).

Does MassHealth cover home births?

Massachusetts has one of the lowest home birth rates in the country.

In order for home births to be eligible for coverage under Medicaid/MassHealth, providers must be licensed

.

Does MassHealth look at your bank account?


MassHealth does not look at your savings

– you can have a large bank account or trust or things like that. But once you turn 65, they look at your assets. For MassHealth Standard you can only have up to $2,000 in savings, although there are certain types of assets that are not counted towards this limit.

Do I make too much money for MassHealth?

Yes, Medicaid / MassHealth looks at your assets, and

they can disqualify you from coverage if you have assets that are over their limit

. In 2021, the asset limit is $2,000.00 for a single person.

Does MassHealth check your income?

MassHealth

uses an electronic data match to compare your current yearly income to your past federal tax return

, if your current income is less, it will ask for proof of your current monthly income.

Do you have to renew MassHealth every year?

Learn more from MassHealth.

Most members will need to resubmit an application to MassHealth every year

so that they can confirm that you still qualify for healthcare coverage.

Does MassHealth expire?


Your MassHealth renewal notice includes a due date

. Unless your notice says that you don't need to do anything, you must respond by the due date listed, or your benefits might decrease or end. If you didn't get a notice asking you to renew, you don't need to do anything now, unless you have had some changes.

Does MassHealth cover wisdom teeth removal?


Dental Services Covered By MassHealth


Oral surgery includes a variety of procedures, one of the most common is the removal of impacted wisdom teeth for teens and adults

. Wisdom tooth extraction requires surgery as the teeth may not come through the gum line.

Does MassHealth cover breast pumps?


Breast Pumps Including double electric pumps, are provided to expectant and new mothers once per birth or as medically necessary or as determined by the member's requesting physicians

and consistent with the provisions of the Affordable Care Act of 2010 and Section 274 of Chapter 165 of the Acts of 2014.

Does MassHealth cover doula?


Doula services are eligible for coverage throughout the Commonwealth of Massachusetts for childbearing individuals through private and MassHealth

. A doula may also be a “Certified Community Health Worker” (as defined by MGL, Chapter 112, Section 259).

Does MassHealth pay for gastric bypass?


MassHealth requires PA for bariatric surgery

. MassHealth reviews requests for PA on the basis of medical necessity. If MassHealth approves the request, payment is still subject to all general conditions of MassHealth, including member eligibility, other insurance, and program restrictions.

Does MassHealth cover non invasive prenatal testing?


MassHealth does not consider maternal cfDNA testing to be medically necessary under certain circumstances

. Examples of such circumstances include, but are not limited to, the following. 1. Maternal cfDNA testing in women with multiple gestations.

Does MassHealth cover hysterectomy?


MassHealth will not pay for a hysterectomy if the purpose is for birth control

. A hysterectomy takes much longer to do than a tubal ligation, and you would be in the hospital longer. There is more discomfort and a greater chance of serious health problems with a hysterectomy.

Does MassHealth cover deviated septum surgery?


MassHealth does not cover orthognathic surgery for cosmetic purposes

.

Does MassHealth cover getting your tubes tied?


MassHealth covers sterilization only when the procedure complies with 42 CFR 441, subpart F, and all other applicable federal and state regulations and subregulatory guidance

.

What is a belt tummy tuck?

A belt lipectomy is

a type of surgery. It's done to remove the loose skin and fat around your waist or “belt line.”

This is also called an abdominal lipectomy, tummy tuck, and panniculectomy. You may have this surgery after you lose a great deal of weight.

What qualifies for a Panniculectomy?

You may be a candidate for a panniculectomy if you:

have recently lost a large amount of weight and have loose belly skin that you want to remove

. are experiencing hygiene issues from excess skin hanging below the pubic region. keep getting ulcers, infections, and other related issues under the hanging skin.

Does insurance cover Panniculectomy?

Cost. A panniculectomy is more expensive than a tummy tuck, but

it's often covered by

. The cost can range from $8,000 to $15,000, plus anesthesia and other extras.

James Park
Author
James Park
Dr. James Park is a medical doctor and health expert with a focus on disease prevention and wellness. He has written several publications on nutrition and fitness, and has been featured in various health magazines. Dr. Park's evidence-based approach to health will help you make informed decisions about your well-being.