Health Connector and MassHealth Update

On February 13^th, the Health Connector announced new steps in the Commonwealth’s effort to preserve coverage for people with health insurance through the Health Connector.  People covered by the Commonwealth Care extension program or who were previously Medical Security Plan members will have access to their coverage through at least June 30, 2014. Previously the Commonwealth Care extension ran until March 31.

Additionally, the temporary coverage program, which currently covers more than 30,000 Massachusetts residents, will also be extended.  More details are included below.

These extensions are critical to supporting the Health Connector’s and MassHealth’s ongoing transition efforts, allowing the Commonwealth to continue its commitment to minimizing gaps in coverage and protecting the insured.

Temporary Coverage Update

MassHealth and the Health Connector are pleased to confirm that the Commonwealth will provide temporary coverage effective February 1, 2014, to applicants who submitted their applications for subsidized coverage in January.  This temporary coverage will be available to those applicants who do not have other coverage through the Commonwealth and who haven’t received an eligibility determination yet.

Temporary coverage for January applicants will be processed in a phased approach but will have a retroactive effective date of February 1.  Applicants who completed an application online, by phone, or in person can expect to receive a letter from MassHealth and the Health Connector about this coverage beginning the week of February 17. Those who submitted a paper application should allow additional time for processing.  Please see the attached FAQs for updated information.

Who is eligible to receive temporary coverage?

Individuals are eligible to receive temporary coverage if:

·         They submitted a new ACA application (online, by phone, in person, or on paper) for subsidized health insurance prior to January 31;

·         They are not currently enrolled in any subsidized health insurance program through the Commonwealth (except for Children’s Medical Security Plan or the Health Safety Net); and

·         The Health Connector and MassHealth have been unable to process their applications and make an eligibility determination.

How will people know if they have temporary coverage?
All applicants who are or will be receiving temporary coverage will receive a letter from the Health Connector and MassHealth informing them about their temporary coverage.

How can people in temporary coverage access services?
Individuals receiving temporary coverage can seek services from any provider that accepts MassHealth. The letter that individuals will receive will contain a Member ID and should be presented when they get health care services.

When will temporary coverage end?
Temporary coverage will end when a full eligibility determination has been made. Applicants will receive another letter with their final eligibility determination.

Commonwealth Choice Member Transition

As a reminder, all of the Health Connector’s Commonwealth Choice plans are ending by March 31, 2014 (if not sooner). Current members must enroll in a new health insurance plan to remain covered.

To ease this transition, the Health Connector is notifying Commonwealth Choice members, who have not already applied for new coverage, of the most-similar Health Connector Qualified Health Plan, as recommended by their current carrier. Instructions on how to enroll in the suggested plan, as well as other health and dental plans offered by the Health Connector, will also be provided.  This option is what we are calling the Fast Path.

To enroll using the Fast Path, Commonwealth Choice members will only need to pay the first premium bill, which will be sent to them if they take no other action.

To shop for other plans, Commonwealth Choice members will be directed to the Health Connector website, where they can also apply online. If they opt to apply for subsidies, the process will take longer to receive a program determination.

Included in this mailing are former Choice members with December 31,  January 31, and February 28 end dates (excluding YAPs), along with those members with a  March 31 end date who have not submitted an application via MAhealthconnector.org.  The mailing will go out to a total of 21,630 subscribers representing a total membership of 31,796.  We are targeting mailing beginning on  February 14. 

Attached is more information pertaining to this transitioning population.

Health Connector Payments

We have heard from many of those who assist consumers that you have encountered circumstances where an applicant has submitted a check or money order payment, however, the applicant then has not received confirmation of enrollment.

The Health Connector has received some payments that do not correspond with enrollment data in our systems. 

What is causing this to happen?

• Individuals are sending payments on behalf of another person (spouse, family member, etc.)
• Dollar value of payment does not match premium amount
• Individuals are sending payments without the payment coupon (invoice attached)

What should you do to help prevent this from happening?
When working with consumers, please ensure that they have completed the online application and plan selection and that they have fully “checked out.”  When sending payments, please remind members to:

1.       Include invoice coupon with their payment

2.       Write the first and last name of the person who is enrolling into coverage and the health plan name that they have selected on the check or money order

3.       Confirm the payment amount matches the amount that is due

We appreciate your assistance as we work to resolve these issues.

The Health Connector and MassHealth