Your benefits
- See a doctor who will help coordinate all of your healthcare
- See specialists (doctors with extra training in an area of medicine, such as cardiology, dermatology, or pediatrics)*
- Have 24/7 access to speak with a nurse about your health questions
- Get coverage for hospital treatments
- Get prescriptions covered at your local pharmacy
- Get access to behavioral health services, including crisis services and no-cost annual screenings
- Get a routine eye exam*
- Get extra help for special conditions such as asthma and diabetes
Select your plan below to see what’s covered – including your free extras. Use the Covered Services List to see what’s covered, what’s not covered, which services require prior authorization, and more.
The Member Handbooks have been recently updated. These updates went into effect on July 1, 2026 and include:
-
Removal of all references to the Community Partners Program, which ended on June 30, 2026.
A summary of additional changes by WellSense include:
All 8 ACOs and MCO:
- Sections 5.2, 5.4, and Chapter 16: Updated references to the Excluded and Limited List to clarify that these items are included within the Covered Services List rather than being provided as a separate standalone document, as previously stated.
MCO Only
- Section 2: Corrected the suite number for the WellSense address. It was previously listed as Suite 100 and has been updated to Suite 200.
- Section 3.3: Replaced “health call needs” with “health care needs” to reflect the intended meaning.
- Section 6.3: Revised the language from “added or from” to “added or removed from” and deleted the duplicate phrase “a drug” in the final sentence to accurately reflect the intended action.
If you would like a printed copy sent to you free of charge, please contact our Member Service team.
| Plan Name | Covered Services List | Member Handbook |
|---|---|---|
| WellSense Community Alliance |
|
|
| WellSense Mercy Alliance |
|
|
| WellSense Signature Alliance |
|
|
| WellSense Southcoast Alliance |
|
|
| East Boston Neighborhood Health WellSense Alliance |
|
|
| WellSense BILH Performance Network ACO |
|
|
| WellSense Boston Children’s ACO |
|
|
| WellSense Care Alliance |
|
|
| WellSense Essential MCO |
|
*Please see the MassHealth Member Handbook and MassHealth Covered Services List for additional information, including which benefits, services and medications are covered or noncovered on our plan and any restrictions or guidelines we must follow before providing them. You can find doctors and hospitals in our network here, see our privacy policies, and learn how we make sure you get the right care at the right time with our Utilization Management policy.
You are leaving the WellSense website
You are now leaving the WellSense website, and are being connected to a third party web site. Please note that WellSense is not responsible for the information, content or product(s) found on third party web sites.
By accessing the noted link you will be leaving our website and entering a website hosted by another party. Please be advised that you will no longer be subject to, or under the protection of, our privacy and security policies. We encourage you to read and evaluate the privacy and security policies of the site you are entering, which may be different than ours.