MassHealth CarePlus Fact Sheet

On January 1, 2014 a new type of MassHealth coverage became available called MassHealth CarePlus for adults age 21 to 65 with income at or below 133% of the poverty level and who are not eligible for Medicare. It is part of the expansion of the Medicaid program under federal health reform.  About 300,000 people were enrolled in CarePlus on its first day including about 135,000 people who had been insured through other MassHealth programs, primarily Basic and Essential which have been replaced by CarePlus and no longer exist. CarePlus does not cover the same Long Term Services and Supports as MassHealth Standard or CommonHealth but individual who need such services can qualify for an upgrade to MassHealth Standard based on "special health needs" also called "medical frailty" without having to complete a disability determination. Care Plus, unlike Basic and Essential, is available to people in MassHealth Fee for Service with MassHealth secondary to private coverage as well as in all the managed care options available including ACO Partnership Plans, MCO plans, Primary Care Clinician Plans and Primary Care ACOs when MassHealth is the only source of coverage. 

Regulations describing CarePlus are at 130 CMR 505.008 

Provider Bulletin 243 (March 2014) also describes the new benefit.

CarePlus Covered Service List for Primary Care ACO and PCC Plan members (Rev 05/2023)