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Neighborhood Health Plan

Neighborhood Health Plan

Today's Globe has a good front page story about what is going on with Neighborhood Health Plan (NHP):

https://www.bostonglobe.com/business/2016/10/26/neighborhood-health-plan-stops-taking-masshealth-members/u3eicAzKNA2DtpU8gAwvcK/story.html

NHP-MassHealth Enrollment Freeze eff. Oct. 18, 2016

NHP is losing money on its MassHealth members. For the time being, MassHealth is closing new enrollment into NHP. The 300,000 people currently enrolled in MassHealth NHP can remain in NHP. There are also 3 exceptions to the enrollment freeze: 

1. babies born to a mother enrolled in NHP can newly enroll in NHP; 

2. people who were enrolled in NHP, lose MH coverage but regain it within the year, will still be automatically re-enrolled back into NHP, 

3. people who leave NHP during the Oct 1-Dec 31 "plan selection period" can return to NHP within the Oct 1-Dec 31 period.

We don't yet know if there will be any options for people enrolled in the ConnectorCare NHP plan who become newly eligible for MassHealth & want to stay with NHP --that is not a current exception. 

The Globe article notes that NHP is the only MH MCO that includes MGH in its network. This is true, but people required to enroll in managed care also have the option of the Primary Care Clinician/Partnership Plan (PCC Plan) & the PCC Plan includes all participating MassHealth medical providers including MGH and the other Partners' Hospitals.

Also we just got the good news that MassHealth has withdrawn that portion of its pending 1115 demonstration request asking to restrict benefits in the PCC Plan.

NHP-ConnectorCare Premium Increase

The Connector "open enrollment" period runs from Nov. 1, 2016 to Jan. 31, 2017 for 2017 coverage. About 70,000 people now enrolled in ConnectorCare plans will need to change their MCO for 2017 during the open enrollment period if they want to avoid premium increases  of 15% or more for 2017 coverage. 

The premium increases are most extreme for most of the 40,000 people now enrolled in NHP.  For example, 4,000 people in Greater Boston now in NHP with 0 premium, will be charged $152 per month if they stick with NHP in 2017; 3700 in Greater Boston now paying $69 per mo for NHP, will be charged $194 per mo if they stay put in 2017. 

People can avoid these huge premium increases for staying with their current MCO by switching to a lower cost MCO.  All the ConnectorCare MCOs offer the same benefits and charge the same copayments. The differences are in what hospitals and doctors are included in the MCO network. There are still 0 premium MCO choices for people with income under 150% of poverty & low cost premium MCO choices for people with income over 150% to 300% FPL--but for many, only if they change MCOs.

WHAT CAN YOU DO?

If you work with low income people, please consider screening for ConnectorCare members who may be affected by these premium increases. Ask about their health insurance.  If they have NHP ask them to look at their cards. If it is ConnectorCare, the Health Connector logo & ConnectorCare will be written on the card. Urge them to call the Connector to find out what their premiums will be in 2017 and shop for a different plan if they need to find a lower cost MCO.

To reach the Connector-

By phone: 

Health Connector Customer Service at 1-877-MA ENROLL (1-877-623-6765) or TTY: 1-877-623-7773.

In-person:

The Connector has 3 year round offices in Boston at 133 Portland St, Worcester at 146 Main St and Springfield at 333 Bridge St. and during Open Enrollment will co-locate Connector staff at Community Health Centers in Brockton, Fall River In Lowell. 

You can find a list of  locations and extended hours after Nov 1 & a list of Enrollment Assistance community based organizations now at:

www.MAhealthconnector.org/help-center