I had a member who is under 65 – apply back in 2012 and get denied for being over income. He is on disability. He wanted to see if he could get approved. At the appointment, I created a HIX application. He got hung up at ID proofing. When calling to unlock the application. CSR […]
I know MA is rolling out the renewals for members. I updated a member’s application yesterday and noticed today they lifted the MA protection, so the member actually qualified for a Connector Plan. Which is fine. However, did all the Federal flexibilities end on April 1? I called MassHealth to ask to “self-attest” to […]
MassHealth put out a provider bulleting talking about the “Hospital-Determined Presumptive Eligibility (HPE)” updated during Covid. It explains the detailed process on how HPE trained CAC’s may determine whether an individual is eligible for HPE application. Is this the same as the HSN Presumptive Determination application? I explained that we as CAC’S can’t do […]
I am working with a client who had BCBS prime and MA 2nd. She entered into a inpatient facility (mental health). Her BCBS termed on 1/2. On 12/29 we enrolled her (online) into the BMC/Wellsense Community, so when the BCBS ended BMC would start with no gap. Trying to be proactive. I know BCBS has […]
I tried to search and see if this question has been answered and didn’t have any luck. I have a client that sold a home about 2 years ago. They have $64,000 in a checking account in the wife’s name, this is after the sale of the house. The husband needs long term care and […]
I have an family over 65. Wife currently has MassHealth Standard. Husband is not eligible at current time. I am helping them doing a senior renewal. Her husband is also applying at this time as he has health issues and is in need of this coverage. They qualify for standard on their income alone. However, […]
I have a client who currently is on hospice. He had work insurance and it ended. Him and his family qualify for MA/Standard. The Hospice place that he goes to only accepts MA/Standard. – Which he has, but when I explained he needs to enroll in a managed care plan, they said “The only plan […]
Has anyone has success in a member not taking the MassHealth Coverage and taking a Connector Care plan instead? I have a member who is protected due to the PHE. They WANT a Connector Care plan instead. I have called MA and they said, call the Health Connector. I call the Health Connector and they […]
I have a client that is over 65 – Needs Long Term Care. He currently has the Senior Buy In. Do we need to do another SACA with supplement A to obtain Long Term Care OR can the nursing home to a SC1 form and convert it over? I have been told different things.
I am having a brain freeze. I have a client that is signing up for a “Health Connector” plan for July. Does the plan deductible go from Jan to Dec. Or would it be from July to July ? I understand that a calendar year deductible would be Jan to Dec and the plan renewal […]