Massachusetts Medicaid (MassHealth) is a combination of Medicaid and the Children’s Health Insurance Program (CHIP) in the state of Massachusetts. MassHealth covers health care costs for certain low and medium-income families and individuals by offering health-care benefits directly or paying part or all of a person’s health-insurance premiums.
Does MassHealth Cover Substance Abuse Treatment?
MassHealth members who are eligible and struggling with drug or alcohol abuse can receive services for substance abuse and mental health through various programs and levels of coverage. These programs and services are available through the Massachusetts Behavioral Health Partnership.
The Massachusetts Behavioral Health Partnership (MBHP) manages behavioral health care for MassHealth Members through a network of more than 1,200 providers. High quality care is available to Members in the following plans:
- MassHealth Primary Care Clinician (PCC)
- Community Care Cooperative (C3)
- Partners HealthCare Choice
- Steward Health Choice
- The Behealthy Partnership
Services offered range from detox, to crisis counseling, to long-term therapy. The MBHP is also dedicated to integrating primary care services with behavioral health services.
Substance Addiction Services
The Bureau of Substance Addiction Services (BSAS) oversees Massachusetts’s system of prevention, intervention, treatment, and recovery support services for individuals, families, and communities affected by substance abuse and gambling addictions. The BSAS is responsible for licensing substance use disorder programs and counselors as well as funding and monitoring prevention, intervention, treatment, and recovery services.
Prevention Services include any program that targets all residents in the community, focuses on particular groups of individuals who are at high-risk for substance abuse, and coalitions that work with multiple partners in a community. These services benefit MassHealth members and the overall population’s health through prevention, early detection, and treatment of substance use risks.
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Regional Centers for Healthy Communities (RCHCs)
The Regional Center for Healthy Communities (RCHCs) exists to address alcohol, tobacco, and other drug use prevention and youth development issues at the local level. Each center has a Resource Library that addresses a large number of topics on public health issues and provides access to several online substance addiction prevention services. Community efforts in prevention focus on availability, community norms, and regulations related to abused substances. Strategies for policy change and implementation, enforcement, education, and communication are created in order to make large-scale changes in the community. Each program focuses on a specific municipality or neighborhood and is carried out by a coalition of organized local volunteers.
Residential Treatment Under 30 Days
Residential Treatment Services under 30 days include Acute Treatment Services (ATS) and Transitional Support Services (TSS). These programs provide short-term acute treatment for those in need of intensive care and support for their alcohol and/or drug use.
Acute Treatment Services (ATS) (Detoxification)
ATS programs are detoxification services with 24-hour nursing care to monitor a person’s withdrawal from alcohol or other drugs and alleviate their withdrawal symptoms. High-risk priority populations include injection drug users, homeless individuals, pregnant women with substance dependency, and other individuals with chronic medical conditions.
Transitional Support Services (TSS)
Transitional Support Services (TSS) are short-term residential support services for individuals who need a supportive environment to continue the recovery process after detoxification. TSS helps those who need services while in between acute treatment and residential rehabilitation, outpatient, or another form of aftercare. To be eligible you must be 18 years or older and referred by a publicly funded ATS detox program, a homeless shelter, or a homeless outreach worker.
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Behavioral Health Integration
Massachusetts Behavioral Health Partnership and MassHealth are working together to integrate physical health care and specialty behavioral health care, including the treatment of substance abuse. Integration aims to improve the continuity of care between inpatient and outpatient behavioral health care and quality of care for co-occurring mental health and substance use disorders.
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