The Online Resource for Massachusetts Poverty Law Advocates

March Health Updates

1.      MassHealth announces its stealth Plan Selection Period  for approx. 1 million mandatory managed care members initially enrolled in ACOs or MCOs on March 1, 2018.     

On March 13, 2019 MassHealth notified Navigators and Enrollment Assisters that-

 “Members who were enrolled in a health plan effective March 1, 2018, are currently in their annual 90-day Plan Selection Period (PSP). Members can enroll in a new health plan or change plans by going online to MassHealthChoices.com or by calling MassHealth Customer Service at (800) 841-2900; TTY at (800) 497-4648.”

However, MassHealth DID NOT notify the affected members that starting March 1, 2019 they have 90 days to freely change to any other managed care plan in their service area. During fixed enrollment, member can only change their ACO or MCO plan for good cause as determined by MassHealth.

 

Stay tuned. It is hard to see how MassHealth can lock these members into a fixed enrollment period after May 31, 2019 when they were never notified of their plan selection period for 2019. 

 

Plan selection and fixed enrollment apply to managed care choices for people who already have MassHealth. Individuals who do not have MassHealth can apply for and enroll in MassHealth AT ANY TIME.

 

2.      Reminder of special enrollment periods for enrollment in ConnectorCare in 2019. 

The Connector open enrollment period ended Jan. 23, 2019. However, individuals can apply at any time and still have options to enroll in 2019. Those found newly eligible for ConnectorCare will still be able to enroll in 2019. Others will be able to enroll if they have a “qualifying event.” More information on qualifying events is available here: https://www.mahealthconnector.org/get-started/special-enrollment-period

And there is one more option for those unable to enroll based on a qualifying event, they can ask for a waiver to enroll from the Office of Patient Protections. 

 

3.      Expansion of MassHealth adult dental to cover additional periodontal codes eff April 22, 2019  

a.       The FY 2019 budget directed MassHealth to expand adult dental to include periodontal services by June 1, 2019. The MassHealth Dental Office issued a notice of new rates & periodontal procedure codes  for services starting April 22 2019 

https://www.massdental.org/~/media/MassDental/Members/Member-Resources/Insurance-and-Coding/MassHealth/FinalUpdatedApril-22nd-Adult-Periodontal-Benefits.ashx?la=en

 

b.      Proposed regs were issued in November 2018 and should be finalized soon.

 

4.      Starting March 1, 2019, working disabled seniors applying for CommonHealth should use the SACA-2 application form. 

The March 2019 revision of the SACA-2 application form has been amended with updated filing instructions and questions to reflect this change. The Mar 2019 revision to the ACA-3 form now only instructs individuals age 65 or older who are the parents or caretaker relatives of children under 19 to apply using the ACA-3. 

 

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