Last day of Connector open enrollment & MassHealth changes
Tomorrow Jan 23 is the last day of open enrollment for coverage through the Connector. That means the last day to apply for coverage and for those eligible for a ConnectorCare plan or Health Connector Plan, to select a plan and pay any premium due in order to be enrolled by Feb 1. It is also the last day for those enrolled in a plan to change plans effective Feb 1. For more information: https://mahealthconnector.optum.com/individual/
Remember, people eligible for MassHealth can apply and enroll at any time of year, and people newly eligible for ConnectorCare or who experience another "qualifying event" (like loss of employer sponsored coverage) can still sign up for Connector coverage after Jan 23.
MassHealth is scheduled to end provisional income eligibility for most adults receiving a request for information for proof of income after Feb 1, 2018.
Today when most people under 65 apply for MassHealth, they can be determined "provisionally eligible" for up to 90 days after a Request For Information is sent out asking them to submit proofs by the 90 day deadline. This rule will still apply to children, pregnant women and certain adults (HIV+ & BCCTP). However, after Feb 1, other adults will no longer be provisionally eligible for MassHealth or Health Safety Net when their self-attested income is within MassHealth income limits but cannot be immediately verified. Instead, they must submit proof of income and have it processed before MassHealth makes a decision about their eligibility for MassHealth or HSN.
Adults with outstanding requests for proof of income who were determined provisionally eligible before Feb 1 will not lose coverage during their 90 day period to submit proof of income.
For affected adults who are new applicants (and those reporting a change in income that would upgrade their benefits) -
* Apply on line if possible in order to see right away whether income verification is required.
*If only able to apply by paper, send in proof of income with the application (but do not delay filing; if eligible, coverage will still date back to 10 days prior to application)
There is no change for ConnectorCare. Adults who are potentially eligible for ConnectorCare will still be able to get a decision right away and enroll in a health plan even if their income is not verified. But they must send in required proof of income (or other proofs) by the 90 day deadline.
On Jan 12, 2017 MassHealth released related regulatory changes in Eligibility Letter 229 posted here:
https://www.mass.gov/lists/2017-masshealth-eligibility-letters
MLRI is working on FAQs with more information on the Provisional Eligibility changes
On a related note, check out this article in Sunday Jan 21 NYT on how when states increase paperwork & reporting requirements, people lose Medicaid.
March 1, 2018 almost 1 million MassHealth recipients will be changing their managed care enrollment.
About 1 million people now enrolled with a MassHealth MCO or in the PCC Plan with the Partnership were sent a green-stripe letter informing them to which plan they will be assigned on March 1 unless they make another choice. About 800,000 were notified they will switch to new ACOs but, according to MassHealth, will stay with the same primary care practice. About 200,000 can stay with the same MCO or PCC Plan they have now. About 100,000 were told to select a new plan by March 1 or MassHealth will automatically assign them to a plan after March 1. Everyone required to enroll in managed care can choose a different plan than the one assigned before March 1, and can freely change their plan after March 1 until May 31.
Help choosing a new plan is available from MH Customer Service which is staffed up and currently reporting no waits, from enrollment assisters at hosptials, health centers and community organizations (listed under Help Center tab on mahealthconnector.org), and at a series of MassHealth enrollment events scheduled around the state.
More information is available from MassHealth here:
https://www.mass.gov/masshealth-health-plans-choices
On Dec 15, 2017 MassHealth released related changes to its regulations in Eligibility Letter 225 here
https://www.mass.gov/lists/2017-masshealth-eligibility-letters