Eligible Members

(A) (1) MassHealth Members. The MassHealth agency pays for substance use disorder treatment services only when provided to eligible MassHealth members, subject to the restrictions and limitations described in MassHealth regulations. Covered services for each MassHealth coverage type are set forth in 130 CMR 450.105: Coverage Types. (2) Members of Emergency Aid to the Elderly, Disabled and Children Program. Covered services for recipients of the Emergency Aid to the Elderly, Disabled and Children Program, are set forth in 130 CMR 450.106: Emergency Aid to the Elderly, Disabled and Children Program. (3) Special Services for Pregnant Members. (a) Eligibility Period. A substance use disorder treatment plan for a pregnant member may provide for no more than 10 consecutive months of service from the initiation of treatment. Services may be initiated as soon as the pregnancy is clinically verified or at any month during the pregnancy. (b) Eligibility for special services for pregnant members continues until the last day of the calendar month in which the 12-month postpartum period ends. Other substance use disorder treatment services described in 130 CMR 418.000 may be available to pregnant members during or after this eligibility period. (B) For information on verifying member eligibility and coverage type, see 130 CMR 450.107: Eligible Members and the MassHealth Card. (C) For limitations on mental health and substance use disorder services provided to members enrolled with a MassHealth managed care provider, see 130 CMR 450.105: Coverage Types and 130 CMR 450.124: Behavioral Health Services.