Services

If you think a decision made by the Massachusetts Health Connector is wrong, you may be able to file an appeal. If you disagree with an action taken by the Massachusetts Health Connector, you may have the right to appeal and ask for a hearing before an impartial hearing officer. Appeal requests must be timely, which usually means they must be submitted within 30 days from the date you received the notice of our action. Decisions you can appeal You can appeal the following kinds of decisions: Whether you’re eligible to buy a plan through the Health Connector Whether you are eligible for subsidies or the amount of your subsidies Whether you are eligible to enroll in a plan during closed enrollment A decision regarding a premium reduction request (only available if you are eligible for ConnectorCare) Your eligibility notice When you apply for coverage, you’ll get an eligibility notice that explains what you qualify for. It will provide appeal instructions for each person in your household, including the number of days you have to file an appeal. If you are not sure if you can appeal a decision, a good way to know is if you get a notice from the Health Connector in the mail and it includes instructions on how to request an appeal, that means you are able to appeal the decision in that notice. Filing an appeal while you are getting [...]

Section Overview As a member of the Health Connector, we are dedicated to providing the best member experience possible. Here, we outline important information about what we provide you, as a member, throughout the year. Types of Information and Services Insurance claim information Detailed insurance benefit information

Section Overview As a member of the Health Connector, we are dedicated to providing the best member experience possible. Here, we outline important information about what we provide you, as a member, throughout the year. Services Health Connector Insurance Bills, sent monthly Requests for information, sent as needed Emails about your coverage Notice of enrollment or eligibility change Notice of renewal, sent every year around Open Enrollment time Forms related to proof of health insurance coverage when filing taxes Help in your language Your right to appeal

Notice of enrollment or eligibility change When you first apply for coverage and you make certain changes to your application, we are required to send you information about your eligibility, even if it may not have changed. This is important because this notice informs you of your legal rights and, therefore, must be sent by mail. As a tip, if you update your information often (for example, if you have a job whose income may change throughout the year), then it may be useful for you to set up a folder to keep this important information in one place. Continually unleash timely processes after magnetic internal or "organic" sources. Professionally expedite compelling alignments and extensible platforms. Quickly underwhelm installed base.

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 →

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 [...]

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.

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 [...]

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.

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