Member Benefits

What We Cover

We cover everything that MassHealth Standard and Medicare plans cover. And on top of that, you pay nothing for these covered services as long as you follow our rules for getting care.

Services you can get at no cost to you

  • Doctor’s visits
  • Prescription and over-the-counter drugs
  • Mental health services
  • Dental exams, cleanings, dentures, root canals
  • Vision care
  • Skilled nursing facilities
  • Hearing services
  • Home health care
  • Inpatient hospital care
  • Durable medical equipment such as wheelchairs, walkers, oxygen tanks
  • Short-term respite care
  • Rides to appointments

Plus, get FREE member perks:

Our members have the opportunity to get additional healthy benefits at no cost. To learn more about these extras, click on the extra benefit below.

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Enhanced Vision Benefit

Money for Prescription Glasses or Sunglasses

Fitness Reimbursement

Get Money Back for Gym or Fitness Purchases

Healthy Rewards Card

 Get Money for Everyday Items

Transportation

FREE Rides to Your Appointments and More


A complete list of covered services is located in your 2020 Summary of Benefits or 2021 Summary of Benefits.

Some Services Require Approval Before You Can Get Them

You may need approval before getting certain care. Some services such as procedures, medications, or visits to doctors outside our network require approval from us before you can get them. This is sometimes called “prior authorization”. Covered services that need advanced approval are marked in your Summary of Benefits document in bold.

Need a service that is not listed? You can request that we cover a benefit that we don't typically cover. Learn how to request services that are not covered

Limitations and restrictions may apply. Benefits, formulary, pharmacy network and provider network may change on January 1 of each year. You will receive notice when necessary. 

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