This message is for children and young adults under the age of 21. It is about well-child care, including behavioral-health care for children and young adults. It is important for children and young adults under the age of 21 to see a primary-care doctor or nurse on a regular basis to stay healthy. These visits are called well-child visits.
Well-child visits
MassHealth pays for members who are under age 21 (except those with MassHealth Limited) to see their primary-care doctor or nurse for well-child visits at least once every year, and more often if the child or young adult is under age two. At these visits, the primary-care doctor or nurse checks the child or young adult’s physical health, dental health, behavioral health, development, and need for immunizations. MassHealth members under age 21 can also visit their primary-care doctor or nurse any time there is a health need.
If either you or your child are under the age of 21, you should be seen by a primary-care doctor or nurse for a checkup even when you are well. By regularly having well-care visits, your or your children’s doctor or nurse can find and treat small problems before they become big ones.
Here are the ages to take yourself or your child for a well-child visit.
- 1 to 2 weeks
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- ages 2 through 20 — once a year
MassHealth members under age 21 who are enrolled in a MassHealth managed-care plan get these visits from their primary-care doctor or nurse in that health plan. MassHealth members under age 21 who are not enrolled in a managed-care plan can get these services from any MassHealth primary-care doctor or nurse.
How to find a primary-care doctor or nurse to do well-child visits if you or your child are enrolled in MassHealth
Most MassHealth-enrolled members under the age of 21 already will have a primary-care doctor or nurse. However, if you or your child are a MassHealth member under 21 and you do not know who your/your children’s primary-care doctor or nurse is, or if you need help finding a primary-care doctor or nurse, you can call MassHealth Customer Service at 1-800-841-2900. If you or your children enrolled in a MassHealth managed-care plan, you can contact the health plan for help, too. The phone numbers are listed at the end of this notice.
Standardized behavioral-health (mental health and substance abuse) screens at well-child visits
Follow-up for behavioral-health issues after well-child visits
Standardized needs assessments conducted by behavioral-health (mental health and substance abuse) providers
Starting in late 2008, behavioral-health providers will assess MassHealth members under age 21 who seek care from them using the Child and Adolescent Needs and Strengths (CANS) tool. The CANS tool will help the behavioral-health provider collect information and make recommendations about behavioral-health needs. The behavioral-health provider will work with you to decide if you (if you are under 21) or your children should be referred for treatment. If you or your children need further treatment, the behavioral-health provider will work with you to create a treatment plan.
Behavioral-health (mental health and substance abuse) services available now
Children and young adults under the age of 21 can get office visits with a behavioral-health provider. If you (if you are under 21) or your children need more services, MassHealth currently covers other services, such as Family Stabilization Team (FST) services. These services are available now for any child or young adult under age 21 enrolled in MassHealth who needs them. Services must be determined to be medically necessary for you or your children before MassHealth will pay for them.
Talk to the primary-care doctor or nurse, the behavioral-health provider, the health plan, or MassHealth Customer Service for information about these services and how to get them.
Behavioral-health (mental health and substance abuse) services for MassHealth Standard and CommonHealth members under the age of 21 available in the future
MassHealth will soon cover several new behavioral-health services for MassHealth Standard and CommonHealth members under the age of 21. These new services will be for children and young adults with a serious emotional disturbance. This also includes children and young adults who have both a serious emotional disturbance and another condition such as autism spectrum disorder. Once MassHealth gets approval from the federal government for these services, we will give you more information about them.
What do I do if my children are not on MassHealth?
In addition to MassHealth, Massachusetts offers several other health-insurance and health-assistance programs at no cost or low cost. To find out if you or your children qualify for MassHealth or any other Massachusetts health-insurance or health-assistance program, call MassHealth Customer Service at the number listed below.
Important phone numbers
MassHealth Customer Service
1-800-841-2900
TTY: 1-800-497-4648 (for people with partial or total hearing loss)
Boston Medical Center HealthNet Plan
1-888-217-3501
TTY: 1-800-421-1220 (for people with partial or total hearing loss)
Fallon Community Health Plan
1-800-868-5200
TTY: 1-877-608-7677 (for people with partial or total hearing loss)
Neighborhood Health Plan
1-800-462-5449
TTY: 1-800-655-1761 (for people with partial or total hearing loss)
Network Health
1-888-257-1985
TTY: 617-806-8196 (for people with partial or total hearing loss)
Primary Care Clinician (PCC) Plan
1-800-841-2900
TTY: 1-800-497-4648 (for people with partial or total hearing loss)
Massachusetts Behavioral Health Partnership
1-800-495-0086
TTY: 617-790-4130 (for people with partial or total hearing loss)
To download this fact sheet in Spanish, click here.