Member Updates

Getting health insurance is an important first step in getting and staying healthy. Follow these guidelines to make sure you are taking care of your health and your coverage.   #1 – Understand your health coverage Check with your insurance plan to see what services are covered, and know whether you will need to pay out of pocket for any services. Be familiar with your costs (premiums, co-payments, deductibles, co-insurance). Know the difference between in-network and out-of-network providers. Know where and when to send payments for your monthly health insurance premium from the Health Connector.   #2 – Know where to go for care Use the emergency department only for life-threatening situations. Use your doctor for preventive health or when it’s not an emergency. Did you know that because of national healthcare reform, most health plans must cover a set of preventive services like shots and screening tests at no cost to you? Find out more about preventive services for adults, women, and children at https://www.healthcare.gov/preventive-care-benefits/adults/   #3 – Find a provider Ask people you trust and/or do research on the internet. Check which providers are in your network by searching on your health plan’s website or calling your health plan’s customer service number. If you’re assigned a provider and you want to change, call your health plan.   #4 – After you have an appointment with a provider Follow your provider’s instructions. Fill any prescriptions you were given, and take them as directed. Review your explanation of [...]

In general, people who are married can only qualify for a premium tax credit if they file a joint tax return with their spouse. However, these rules have recently changed for anyone who is the victim of domestic violence. If you are the victim of domestic violence, filing a tax return separately from a spouse will no longer prevent you from being able get help paying for coverage through premium tax credits. Because this rule was recently announced, the Health Connector will have a special enrollment period from April 1, 2014, to May 31, 2014, for anyone that this situation applies to. The special enrollment period allows victims of domestic violence to apply for and enroll in health insurance outside of the recently closed open enrollment period. If you are a victim of domestic violence who did not apply for coverage through the Health Connector during open enrollment: Go to MAhealthconnector.org and fill out a new application When asked for information about how you plan to file next year’s federal income tax return, indicate that you will file as single/unmarried Do not include your spouse on the application and do not include your spouse’s income when answering questions about the household income You may also be asked to confirm that you are applying for coverage outside of the open enrollment period because the special enrollment related to domestic violence applies to you If you are a victim of domestic violence who: Is currently enrolled in a Health Connector Plan without help paying for coverage, or Tried [...]

If you are losing your health insurance from your employer, you have options to consider as you pursue finding new coverage. If you can access coverage through your spouse or through a government-sponsored program, those are options you should research and consider. If those options are not available to you, the Massachusetts Health Connector can help you access health insurance. For those who meet eligibility standards, the Health Connector provides people with help paying for their health insurance and also provides a wide range of plans to those who qualify for help paying for their health insurance. Your anticipated annual income is the main factor in determining whether or not you qualify for help paying for your insurance. The Federal Poverty Level, or FPL, is a measure of income level published each year by the Department of Health and Human Services. Federal poverty levels are used to help determine your eligibility for certain programs and benefits. The 2022 Income Standards and Federal Poverty Levels are used to determine who may be currently eligible for MassHealth programs The standards will be updated in early 2023 for the current year. The 2022 Federal Poverty Levels are used to determine who may be eligible for Health Connector or ConnectorCare plans during the current 2023 plan year that ends December 31, 2023. FEDERAL POVERTY GUIDELINES 2022 MassHealth Income Standards and Federal Poverty Guidelines Family Size MassHealth Income Standards 100% Federal Poverty Level 130% Federal Poverty Level 133% Federal Poverty Level 150% Federal Poverty [...]

The current open enrollment period closed on March 31. However, if you tried to apply through the Health Connector during open enrollment for health insurance without help paying for costs, but were unable to complete enrollment because of IT systems issues (such as website errors), you will now have until April 15 to enroll in a plan. Because of IT system issues, not everyone who tried to apply for health insurance has been able to complete the process. Trouble with completing enrollment will now be considered a qualifying event that allows you to shop through the Health Connector after open enrollment has ended during this limited time only (April 1–April 15). If this situation applies to you, you will need to pick a plan by April 15 that starts either May 1 or June 1, and pay the first premium by its due date in order to be enrolled. You will need to confirm that you tried to apply online or over the phone during the open enrollment period, but were not successful in doing so. In general, the open enrollment period is the only time of year when people who are applying for coverage without help paying for costs can enroll or change a plan for any reason. However, when a person experiences a qualifying event such as birth of a child, marriage, or loss of insurance through a job, the Health Connector allows that person to enroll in health insurance outside of open enrollment. Applications can be completed [...]

The current open enrollment period closes on March 31. However, if you tried to apply through the Health Connector during open enrollment for health insurance without help paying for costs, but were unable to complete enrollment because of IT systems issues (such as website errors), you will now have until April 15 to enroll in a plan. Because of IT system issues, not everyone who tried to apply for health insurance has been able to complete the process. Trouble with completing enrollment will now be considered a qualifying event that allows you to shop through the Health Connector after open enrollment has ended during this limited time only (April 1 – April 15). If this situation applies to you, you will need to pick a plan by April 15 that starts either May 1 or June 1, and pay the first premium by its due date in order to be enrolled. You will need to confirm that you tried to apply online or over the phone during the open enrollment period, but were not successful in doing so. In general, the open enrollment period is the only time of year when people who are applying for coverage without help paying for costs can enroll or change a plan for any reason. However, when a person experiences a qualifying event such as birth of a child, marriage, or loss of insurance through a job, the Health Connector allows that person to enroll in health insurance outside of open enrollment. People who [...]

Commonwealth Care coverage for current members has been extended again through June 30, 2014. You do not need to take any action at this time to continue to get coverage, other than paying your premium bill in full and on time (if you have one). If you already re-applied through the Health Connector At this time, we have not yet been able to process your application. We apologize for any confusion, miscommunication, or delays you have experienced if you already submitted a new application for insurance through the Health Connector. As you may already know, our new website has not been performing the way that it was intended to. This has caused extreme difficulties in our ability to process any applications—whether submitted online, through a paper application, or over the phone—because we cannot determine eligibility for our members without this technology working. We are currently working to fix the systems that are necessary in order to be able to process your application. You will be contacted by phone and/or mail once we have determined which plans you can qualify for, and you will be able to choose a new plan and enroll at that time. However, you will continue to have health insurance coverage through Commonwealth Care until at least June 30, 2014. You will still have an opportunity to enroll in one of the new plans available through national health reform: If you already applied for new health coverage, you will be able to enroll in a new plan [...]

On February 13, 2014, the Health Connector, with support from the federal Center for Medicaid Services (CMS), announced three new steps in the Commonwealth’s effort to preserve coverage for people with health insurance through the Health Connector. Commonwealth Care and Medical Security Plan Members Commonwealth Care members and those who were previously in the Medical Security Plan (MSP) will have access to coverage through at least June 30, 2014. Previously, the extension ran until March 31, 2014. However, please note that some members may need to move to a different health plan. All members will receive a detailed notice in the mail. Temporary Coverage Program For members enrolled in the temporary coverage program, this program will also be extended until June 30, 2014 for those who are not successfully transitioned to coverage before that time. Commonwealth Choice Members Commonwealth Choice members will be offered a “Fast Path” to coverage in addition to shopping through the online system. Members who have not already enrolled in a new plan will have the option to “Sign, Pay, and Enroll” entirely offline into a new plan. The Health Connector has worked closely with the carriers to find plans that are most comparable to current plans through Commonwealth Choice. Starting the week of February 17, 2014, Commonwealth Choice members will receive an enrollment package by mail about their new plan options that will include  the opportunity to enroll by paying their first month’s premium. However, members are still free to shop for different coverage through the [...]

Temporary Coverage information and resources Read this important information about temporary coverage extension. If you have questions or need more information please call 1-855-MA-4-HLTH (855-624-4584). Toggle   If you submitted an application for subsidized coverage but have not received a determination for benefits, you will most likely be automatically enrolled in temporary health insurance coverage that starts January 1, 2014. You will continue to get this temporary coverage until we are able to determine which plans and programs you can qualify for. If this applies to you, you should get a letter in the mail with more information. You will not need to take any immediate action or make any payment to get this temporary coverage. If you qualify for temporary coverage: You will not need to take any action or pay any money to get this temporary coverage. You will be enrolled automatically for coverage. Your temporary benefits will cover a wide range of health care services. Read the Summary of Benefits for a list of covered services. You can get covered health care services from providers that participate in the MassHealth program. You will get a letter when we finish processing your application letting you know if you qualify for a health insurance plan through the Health Connector or through MassHealth. Once we have processed your application and made a decision about your eligibility, your temporary benefits will end.   What kind of care does this cover? Read the Summary of Benefits for a list of services that are covered through the Temporary [...]