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New Year News

With the new administration, EOHHS has a new secretary, Mary Lou Sudders, formerly Mental Health Commissioner from 1996-2003,  the Office of Medicaid has a new interim Medicaid Director, Robin Callahan, formerly Dep. Director of Medicaid, and the Connector has a new Ex-Officio board chair, the Secretary of Admin & Finance, Kristen Lepore (most recently at AIM), and a new interim director Maydad Cohen. Cohen also continues his role as fixer in chief of the Connector website at least through open enrollment which ends Feb 15, 2015.
Open enrollment deadlines
Over 400,000 people who were enrolled in Commonwealth Care, the Medical Security Program (MSP), or temporary MassHealth coverage have now all been notified that their benefits are ending and they must reapply if they want their health benefits to continue after the end date of their current coverage.
  • Commonwealth Care & Network Health Extend (formerly MSP) coverage ends Jan. 31, 2015.  Those now enrolled must reapply & if eligible for the successor program ConnectorCare or other Connector coverage, select a plan, and pay any premium due by Jan. 23, 2015 in order to have Connector coverage on Feb. 1, 2015.
  • The first and second wave of people enrolled in MassHealth temporary coverage who received a purple or blue open enrollment letter telling them that their coverage will end in Jan. 2015  must reapply to have coverage in Feb. 2015. Those eligible for ConnectorCare or other Connector coverage face the same Jan. 23 deadline to select a plan and pay any premium due for Feb 1 coverage.
  • The third wave of people enrolled in MassHealth temporary coverage who received a green open enrollment letter have coverage ending Feb. 15, 2015. They must reapply by Feb. 15, but if they do so, and are eligible for the Connector, they will have until Feb. 23 to select a plan and pay any premium due for March 1 coverage and their temporary coverage will continue to the end of February.
  • People in coverage that is ending who reapply and  are eligible for MassHealth, will still have 10 days of retroactive coverage and their enrollment is not contingent on selecting a plan or paying a premium. 
  • Open enrollment ends Feb 15, 2015. This is the last day for people to apply for unsubsidized coverage or for those between 300%-400% of poverty to enroll in Connector coverage with a tax credit.  People can  apply for MassHealth or ConnectorCare after Feb. 15. 2015, but those in coverage that is ending may face gaps in coverage if they do not apply and enroll by the open enrollment deadlines. 
Open enrollment progress to date
From Nov 15, 2014 when the new system started making eligibility decisions and Jan. 14, 2015, 359,506 people have been determined eligible and 246,177 actually enrolled in coverage. This includes 129,000 people formerly on temporary MassHealth :  68,000 found eligible for MassHealth, 39,000 eligible for ConnectorCare of whom 12,200 have enrolled, and 22,322 with income over 300% FPL eligible for a Qualified Health Plan (QHP). It also includes 56,000 people formerly on Commonwealth Care: 16,000 found eligible for MassHealth, 32,000 eligible for ConnectorCare of whom 14,000 have enrolled and 8,000 with income over 300% FPL eligible for a Qualified Health Plan. This information & more is posted here:
Where to get help applying and enrolling
People who need to reapply can do so on-line at, by telephone 877-623-6765 (Connector Customer Service) or 800-841-2900 (MassHealth Customer Service), in-person at a MassHealth Enrollment Center or the Portland or Worcester Connector walk-in centers or by mail. On-line applications are the fastest way to apply especially for people who must meet the Jan. 23 or Feb. deadlines to remain insured. If an online application is successfully submitted, the applicant will get back a real time eligibility decision and, in the Connector, can go on to select and pay for a plan.
To apply on-line, you must have an email address & be able to pass "identity proofing" through the Experian credit reporting agency to prove that you are you. If someone gets stuck on identity proofing, they can fax in identity documents and should be able to proceed with their on-line application a few days later. It is worth trying to apply on-line for most people. HOWEVER, someone who does not have proof of identity such as a driver's license, US passport, or foreign passport is better off submitting a paper application and not trying to apply online --the stuck online application will mess up processing of a later paper application.
The Connector website lists health care providers and nonprofit organizations that provide application assistance at this website:
New fax number for applications (except for long term care) and verifications (except identity proofing)
Effective immediately, ACA-3 applications, and other verifications (except for identity proofing) should be faxed to a new number. Attached is a sheet distributed at the January MassHealth Training Forum titled Where can I send Documents or Verification Information? with the latest on mailing addresses and fax numbers. This information is also posted along with an updated Income & Immigration Guide and other useful resources on the MTF website under meeting materials for Jan 2015:
Updated MassHealth Provider regulations on gender dysphoria including gender reassignment surgeries and hormone therapies and several other services were released in January 2015. Look for Transmittal Letters in the Provider Library on the MassHealth website. 
Stay tuned: Redetermination and mid-year budget cuts
After a redetermination hiatus of over 12 months for people under age 65 (with the OK of CMS), MassHealth resumed redetermination last month and plans to have 1.2 million MassHealth recipients renewed over the course of 2015.
The new Governor has announced a $760 million deficit in the FY 15 budget and expects to release his plan for addressing the deficit shortly. With health spending such a large share of the state budget, it is likely to be affected by any deficit-cutting plan.