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Rules and Benefits for American Indians and Alaska Natives

Who qualifies as an American Indian/Alaska Native? For Health Connector purposes, an American Indian/Alaska Native (AI/AN) is defined as a person who has either been verified as having AI/AN status, or has attested to being an AI/AN and is waiting for verification of AI/AN status. For MassHealth purposes, federal regulations define AI/AN to mean any individual who is a member of a federally recognized Indian tribe; resides in an urban center and meets one or more of the following four criteria: is a member of a tribe, band, or other organized group of Indians, including those tribes, bands, or groups terminated since 1940, and those recognized now or in the future by the  state in which they reside; or who is a descendant, in the first or second degree, of any such member; is an Eskimo or Aleut or other Alaska Native; is considered by the U.S. Secretary of the Interior to be an Indian for any purpose; or is determined to be an Indian under regulations promulgated by the U.S. Secretary of the Interior; is considered by the U.S. Secretary of the Interior to be an Indian for any purpose; or is considered by the U.S. Secretary of Health and Human Services to be an Indian for purposes of eligibility for Indian health care services, including California Indian, Eskimo, Aleut, or other Alaska Native. What are the rules for an AI/AN seeking or receiving Health Connector and MassHealth benefits? Applying If someone applies for health coverage and [...]

What to Expect: Email Communication

From time to time, you may get important emails about your coverage or actions you need to take to make sure that you stay covered. These include information about yearly tax forms and where you can find important information online, information about Open Enrollment and renewals, and important deadline reminders. Be sure to keep email address updated so that we can send you important information throughout the year. Learn how to update your contact information here →

Canceling coverage

Am I responsible for canceling my own coverage? YES. If you no longer need health or dental coverage through the Health Connector, you must cancel your own coverage in most circumstances. There are 2 exceptions: If you update your account and are determined eligible for MassHealth coverage, your coverage may be automatically canceled at the end of the current coverage month. If you update your account and are determined not eligible for coverage through the Health Connector, your coverage will be automatically canceled at the end of the current coverage month. When should I cancel my coverage? As a Health Connector member, you have a right to cancel your health or dental plan at any time. But the day of the month when you cancel your plan is very important. If you need to cancel a health or dental plan for next month, then you must cancel the plan by the 23rd of the current month. Your coverage end date is the last day of the month that you request your plan cancellation even if you cancel before the 23rd of the month. Otherwise, your coverage will end the last day of the following month. So, if you cancel your plan on or before the 23rd of the month, you will still be covered through the last day of that same month. If you cancel your coverage the 24th of the month or later, you will be covered for the entire following month if you paid your monthly premium. [...]

Detailed insurance benefit information

For detailed benefit information, you will need to contact your health or dental insurer directly. If you are a member, most insurance companies have a member services portal that includes their member guides and detailed benefit information about the plan you are enrolled in. Or, you can call their member services call center directly. See the “Who to contact and when” section for contact information.

What to Expect: Help in your language

The Health Connector is dedicated to making sure that all members have access to information in their language. As a member of the Health Connector, you have a right to access to interpretation services, at no cost to you. The Health Connector has dedicated Spanish-speaking customer service representatives. You can access a Spanish speaking representative or be connected to a telephonic interpreter for other languages by calling Health Connector Customer Service at 1-877-623-6765 (TTY: 711). A Customer Service representative will connect you to telephonic interpreters who can speak in your preferred language. This service is also available through our walk in center locations, and at hearings for appeals. You may also ask for an American Sign Language (ASL) interpreter. These interpreters can provide ASL interpretation at the Health Connector’s walk in center locations or at the Appeals unit after an appointment or hearing date is requested. Appointments are requested through the walk-in centers, through the Health Connector Appeals staff, or by phone with a Customer Service representative. You can find more information about access for members who speak other languages in our Language Access Plan, available on our website at www.MAhealthconnector.org/site-policies/language-rights

Advance Premium Tax Credit

If you are getting a tax credit to help you pay for your health insurance premiums throughout the year, there are two important things you’ll need to remember to do: 1: Let us know if anything changes throughout the year This includes changes to your home address, family size, income, or access to health insurance (such as through a job, Medicare, and other sources). If you have changes but don’t update your information, you could end up owing the IRS money at tax time.  You can update your information online through your account at MAhealthconnector.org. Make sure to submit any changes you make on the Rights & Responsibilities page. 2: File your taxes You must file federal income taxes for every year that you get tax credits. You will need to file even if you haven’t had to file in the past, or wouldn’t normally need to file because of your income. We’ll send you a 1095-A form at the end of January. This form shows how much was paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962 when you file your taxes. Why is this important? You’ll need to file taxes at the end of the year so that the IRS can be sure that you got the right amount of tax credit based on what your income was that year. This process is called [...]

Filing your taxes

Why does filing my taxes matter? As shared in the previous section, if you receive an Advance Premium Tax Credit to help lower your premium costs, you must file your taxes each you receive this tax credit to be eligible for this saving the next year, or any future year. This is true even if you receive the tax credit only part of the year. This is true even if your income is low enough that you haven’t needed to file taxes in the past. What information will the Connector give me? To file your taxes, we’ll send you a 1095-A form at the end of January. This form shows how much was paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962 when you file your taxes. What resources are available? If you need help filing your taxes, many people can get free tax help from programs such as Volunteer Income Tax Assistance (VITA) and Tax Counseling for the Elderly (TCE). Call the IRS hotline at 800-906-9887 to find a location near you. You can also visit MAhealthconnector.org/taxes for more information on how to get free help with your taxes. When is the best time to file? The best time to file is after you have received all of your tax filing documents, including those related to your health insurance. If you were covered by different types of insurance during [...]

What to Expect: Renewal notices

Notice of renewal, sent every year around Open Enrollment time Each year during Open Enrollment, Health Connector members are able to shop and change plans for any reason without a qualifying event. If you are enrolled in a health plan through the Health Connector, your coverage year will end December 31. Your renewal notice includes information about Your eligibility that includes the types of coverage and help paying for costs you and your family members may be eligible for. Your current plan and if it is available the next year. Your next year’s plan, which could be the same plan, if it is available, or the most similar plan that is available if it will not be the next year. Your plan premium costs for the next year, if you have no changes to make. Your renewal information will include information about your next year’s plan (your current plan or the plan most similar to your current plan), what you need to do to keep this plan and or how you can shop for a different plan. You will also be encouraged to review your application and update personal information if needed. Please note that if you are enrolled in both a health and dental plan that all plans’ coverage year ends on December 31. See the example below: Coverage start dateCoverage year end dateMarch 1, 2023December 31, 2023 When it is time to renew your dental plan, you will [...]

Health Connector Insurance Bills, sent monthly

Members enrolled in a Health Connector plan who have a premium are mailed a bill each month to the mailing address on file. If you are signed up for paperless billing, you can see your bill in the Payment Center. Our billing schedule is as follows: The monthly bill is generated on the 1st of each month and mailed to enrollees. The monthly bill is delivered to the enrollee by mail, usually within 6 business days after the 1st of the month. If you are signed up for Paperless billing, your bill is available sooner online. The monthly bill is for the next month's coverage. For example, you will receive your June bill at the beginning of May. The monthly payment is due on the 23rd calendar day of the month. Members have the opportunity to sign up and pay their bill online. WATCH: Understanding your Health Connector bill Watch our video walkthrough of the the different parts of the redesigned Health Connector bill that is easier to understand and includes definitions and your recent payment history.

What to Expect: Requests for Information, sent as needed

The Health Connector uses federal and state electronic data sources to validate (confirm) information you enter in your application. These data sources include agencies like the IRS, Social Security Administration, Massachusetts Department of Revenue, Department of Homeland Security, and others. When you first apply for coverage or make changes to your application during the year, there may be times when the state and federal electronic data sources we use could not validate (confirm) the information you provided. If this happens, you will need to send proof to us so we can confirm the information that could not be validated electronically. The proof we request is specific to an enrolled individual, member. You will always find the type of proof you need to submit, including any document(s) you need to send, in the letter you’ll get in the mail. Learn more about requests for information

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