MassHealth Renewals, CarePlus and Fallon Total Care

1. MassHealth Renewals

Extension to Oct 16 for people with disabilities.

In August MassHealth notified about 35,000 households containing 62,000 individuals with at least one member with a disability that they had to submit a reapplication by Sept 15 to remain eligible for MassHealth. The deadline has now been extended to Oct 16.  MassHealth is sending out reminders on Oct 2 & 5 to people who were notified in August & have not yet submitted a reapplication.  A copy of what the notice will look like is attached.  Please be on the look out for anyone who gets one of these notices. They need to take action to avoid losing MassHealth benefits! The notice explains where help is available to reapply. 

Third round of renewal notices to Standard, CarePlus and Family Assistance members-Oct 16 deadline.

On September 1 MassHealth notified about 65,000 households including over 150,000 individuals that they had to submit a reapplication by Oct 16 to retain their benefits. MassHealth held 5 enrollment events around the state during September. People can apply on-line, in person at a MassHealth office or over the telephone. Help is available from trained enrollment assisters at provider and community organizations around the state. 

Are you seeing MassHealth members who already lost benefits?

The first round of 500,000 people up for renewal initially had until deadlines in March to renew. Many were terminated in April but some were temporarily reinstated until June 30 and given another chance to reapply. About 140,000 people lost MassHealth benefits in April or July for not completing the reapplication and another 20,000 were denied either MassHealth or Connector benefits in the first round of renewals.  
What happened to these 160,000 people? The silence is deafening. 

Please let us know if these people are surfacing & looking for help reinstating their benefits: or

2. Good news on CarePlus --more choices for consumers soon

CarePlus is the Medicaid expansion program under the Affordable Care Act --since Jan. 2014 it has provided MassHealth benefits to adults with income not over 133% of the poverty level who would not otherwise be "categorically eligible" for Medicaid. People eligible for CarePlus were initially enrolled in fee for service benefits & then enrolled in a Managed Care Organization on the first of the month. However, unlike other MassHealth beneficiaries, they did not have a choice to enroll in the Primary Care Clinician (PCC) Plan. MassHealth has now proposed a rule to give CarePlus members more choices --one of the MCOs or the PCC Plan. The proposed rule is posted here: 
The notice says the changes will not go into effect before Oct. 23. 

3. Fallon Total Care drops out of One Care on Sept 30 -help with transition available.

Fallon Total Care was providing a combined Medicare-MassHealth benefit to about 5400 dually eligible individuals with disabilities in Central & Western Mass until Sept. 30 when it ended its participation in One Care. Most people enrolled in Fallon will be returning to MassHealth fee for service and traditional Medicare on Oct 1. The Office of Medicaid and Medicare are available to help with  access to care problems during the transition period for these members, see the information below.

For access to care issues relating to MassHealth covered services:

please contact Shelia or Roseanne Mitrano 

For access to care issues relating to Medicare covered services or Part D prescription drugs:

please contact Matt or Tim Pappalardo