Thousands of MassHealth Households Subject to Termination for Non-Payment of Premiums

Starting in March, somewhere between 5,000 and 10,000 MassHealth households who are currently responsible for premiums will receive notices that they are in substantial arrears on their monthly MassHealth premiums, and that they will be put on a six month payment plan to pay off their arrearage. Failure to comply with the terms of the premium arrearage plan as well as keeping current with their on-going premium obligation will result in termination of the household's MassHealth benefits.

Only households who are currently subject to a premium payment (i.e. most households with incomes over 150% of poverty) will be subject to benefit termination. There are others who may owe back premiums, but who are not currently premium payers. These households will still owe their premiums and will be subject to collection efforts by the state to recover these premiums, including possible the intercept of tax refunds, but they will not be subject to benefit termination if they are currently in a non-premium paying category.

MassHealth is waiting to apply these new arrearage policies until after the March 1st date on which the new federal poverty level calculations become effective for the MassHealth programs. This means that some households will move from being households with current premium obligations by being above the former 150% of poverty, premium paying, standard to being below 150% of the new standard, and therefore not responsible for current premiums. Advocates will continue to press the Administration to develop payment plans that are within the capacity of households with these arrearages, but the Administration is committed to dealing with their premium collection policies and will sanction households who fail to comply with their repayment plan.

So What Should You Do When You See These Notices? Take the notices seriously. Although MassHealth has been lax up to date in its enforcement of premiums, those days are now over. People with arrearages who do not pay their payment plans and keep their current premiums paid up to date will be terminated. Make sure that the household is still subject to premiums. If the household with arrearage is not currently a premium payer they are not subject to termination, even though MassHealth will still try to collect the owing arrearage Keep in mind that households terminated from MassHealth for non-payment of premiums are ineligible for coverage under the Health Safety Net!

We will continue to keep you informed of developments on MassHealth's new approach to premium collection, and its arrearage and sanction practices. Please keep Vicky -617-357-0700(extension 318) and Neil (extension 309) appraised of what you are seeing in this regard.