The 2012 MassHealth Advocacy Guide, An Advocate's Guide to the Massachusetts Medicaid Program. Includes an overview of the MassHealth program, eligibility criteria, covered services, premiums, and appeal rights. IMPORTANT UPDATE: Many changes in MassHealth and other subsidized coverage rules took effect Jan. 1, 2014. Unfortunately, implementation of many of the Jan. 1, 2014 rule changes have been delayed by the failure of the new eligiblity & enrollment system. The "workarounds" to address the system failures are changing with great frequency. For this reason the 2012 Guide should be used with caution. It can still be a useful tool to help you identify citations to relevant regulations, but you cannot rely on the Guide's summary of the regulation. In addition to looking up the current text of the regulation, look at the Health Reform section for summaries of the Jan 2014 rules and visit the following website for updates on the current status of the "workarounds": https://www.mahealthconnector.org/about/pressroom/connector-updates
Dowload the following PDFs for free:
- March 2013 Updates and Corrections to the Guide
- Table of Contents
- Parts 1 (Overview of MassHealth) and 2 (Massachusetts Residence)
- Parts 3 (Relationship Between MassHealth Eligibility and Reciept of Cash Assistance) and 4 (Application and Eligiblity Determination)
- Parts 5 (Eligibility Criteria for Children), 6 (Eligibility Criteria for Pregant Women) and 7 (Eligibility Criteria for Parents and Caretaker Relatives)
- Parts 8 (Eligibility Criteria for Disabled Adults 18-64) and 9 (Eligibilty Criteria for Other Adults Under Age 65)
- Parts 10 (Eligibility Criteria for Uninsured Adults in Commonwealth Care) and 11 (Eligibility Criteria for Adults Age 65 and Older)
- Parts 12 (Financial Eligibility) and 13 (Eligibility Rules About Citizenship and Immigrations Status)
- Parts 14 (Other Eligibility Rules) and 15 (Covered Services)
- Parts 16 (Service Delivery) and 17 (Premiums and Cost-Sharing)
- Parts 18 (Notice and Appeal Rights), 19 (Health Programs Other Than MassHealth) and 20 (Sources of Additional Information)
You can also download a PDF of the entire volume; note that this is a very large file, and may take several minutes to download.
A hard copy of the Guide can be ordered from MCLE; the Guide currently costs $9.95.