Massachusetts

The below coverage applies to all fully insured commercial Massachusetts plans. Most self-insured plans do not provide this coverage. If you are covered under a self-insured plan that includes this coverage, the benefits will be listed in your benefit handbook. 

Massachusetts Plans – Expanded Access to Treat Child-Adolescent Mental Health Disorders

Bulletin 2018-07 from the Massachusetts Division of Insurance and the Executive Office of Health and Human Services, Department of Mental Health requires that commercial health plans provide coverage of certain child-adolescent mental health services on a non-discriminatory basis for the diagnosis and treatment of mental health disorders that substantially interfere with or substantially limit the functioning and social interactions of the child or adolescent through the age of 18. The bulletin states that “child-adolescent mental health services” shall consist of a range of inpatient, intermediate and outpatient services that shall permit medically necessary and active and noncustodial treatment for said mental disorders to take place in the least restrictive clinically appropriate setting. This may include the member’s home or a program in another community-based setting. The services can be provided to the child, the child’s parent(s) and/or other caregivers. The following outpatient services for children and adolescents will be covered effective January 1, 2021:

Outpatient services for children and adolescents: 

• Family support and training (FS&T) – a service provided to a parent or other caregiver of a child to improve the capacity of the parent or caregiver to ameliorate or resolve the child’s emotional or behavioral needs and to parent.
• Therapeutic mentoring (TM) services – services provided to a child designed to support age-appropriate social functioning or to ameliorate deficits in the child’s age-appropriate social functioning.
  
  Please refer your benefit handbook for additional details. You can also access the Bulletin at: https://www.mass.gov/files/documents/2018/12/14/BULLETIN%202018-07%20%28Child-Adolescent%29.pdf.

If you need assistance locating a provider, please contact us at (888) 777-4742.