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MassHealth Cost Sharing Update

December 29, 2020

MassHealth made the following changes to their cost sharing policy effective July 1, 2020:

  • Pharmacy copays for members with incomes at or below 50% FPL and for members categorically eligible for MassHealth because they are receiving other public assistance was eliminated.
  • Copays for FDA-approved medications for detoxification and maintenance treatment of substance use disorders (SUD), preventive services rated Grade A & B by the US Preventive Services Task Force (USPSTF) or broader exclusion specified by MassHealth, and vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP) was eliminated for all members.
  • And, acute inpatient hospital copays were eliminated for all members on 03/18/20.

Additional cost sharing changes will be implemented effective July 1, 2021. More information will be available early Summer of 2021, and be on the look-out for registration information.