I wanted to make sure that everyone is aware that caretaker relatives who are 65 or older that apply through HIX and qualify for MassHealth Standard are not automatically also receiving the Medicare Buy-In. In order to make sure the applicant receives that benefit, you have to call the MassHealth Enrollment Center and have them manually correct the determination on […]
I wanted to make sure folks were aware of the following issue since neither MassHealth/HSN has published information about it (but the HSN helpdesk has confirmed it). There is currently a systems issue affecting the tracking of temporary HSN eligibility in EVS. Specifically, when a ConnectorCare eligible individual’s 100 days of temporary HSN has expired, EVS may still display […]
Has anyone else been experiencing fax issues to the EDMC or CPU fax # over the past two weeks? I’m trying to diagnose whether our problem is just internal or whether there’s an issue on MH’s end as well. If everything is good on your end, please let me know.
I haven’t seen MassHealth publish this information to the Assister community yet (it was provided to the MCO/ACOs on 10/26/17), but just so everyone is aware, MassHealth assignment logic is no longer allowing members to enroll into MCOs that are being sunsetted on 02/28/2018 (i.e. Celticare, HNE, Fallon, and Neighborhood Health). Members can only select from the non-sunsetting […]
HIX was updated over the weekend and one of the changes is a new question regarding the effective date of earned income. Prior to the deployment of HIX, MA-21 used this question to determine whether a family was eligible for Extended Eligibility (or TMA) benefits. [The applicable Extended Eligibility rules, for those unfamiliar: Members of a MassHealth […]
Does any other hospital struggle with MassHealth’s processing of NOB forms? We’re encountering so many cases where they either don’t get processed, or are sent to another agency (such as the DTA) and then processed with an incorrect benefit start date for the newborn. It’s becoming a Herculean task to get these fixed.
When an SSI recipient has a question about their referred Medicaid/MassHealth benefit or needs to get it activated/re-activated, who exactly are they supposed to contact (e.g. what phone number)? The MH Enrollment Center/Customer Service defers questions about SSI recipients to Social Security, and our local Social Security office defers questions re: MassHealth to our office. We used […]
Has anyone else experienced difficulty removing family members from an application? We have several cases where when we try to remove a member (due to no longer being part of the household, although the other options don’t work either), the application gives a yellow triangle after the “Tell Us About Your Household” tax filing page.
Has anyone else experienced issues with ConnectorCare enrollments on the carrier end, particularly Tufts? We continue to encounter cases where an individual selects a carrier through the Connector, pays their premium (if applicable), and then doesn’t get enrolled with the carrier. Or, if the Health Connector makes an adjustment to an enrolled member’s effective dates, the carrier doesn’t […]
One of the categories of MH members who are excluded from MCO participation is “a member who is receiving hospice care through MassHealth on a fee-for-service basis, or who is terminally ill as documented by a medical prognosis of a life expectancy of six months or less”. Does anyone know which MH unit is responsible […]