I am looking for some clarification on a situation I encountered today with a new client. He is married, but him and his wife file separately. His wife has ESI, but he cannot enroll because it is not open enrollment and he is over the 60-day qualifying event period. Does he qualify to be on […]
I am looking for advice on how I can help someone who has cancer. Him and his wife have an income over the limit for any of the buy-in programs, so they have an advantage plan that has some high costs associated. I do not think he will qualify for a Frail Elder Waiver, because […]
Does Masshealth cover the co-pays from part d prescription plans if someone has masshealth as a secondary or senior buy-in?
I am working with a client who is married, but they have separated, and now live in 2 different households. She added her wife to insurance for a short time, but then cancelled the whole policy because it became too expensive. How will this affect her taxes as they will not be filing jointly for […]
Multiple MH members are reporting that they are receiving delta dental cards in the mail, or their dental office is telling them that delta has been added to their child’s insurance. It is not showing on revs? IS MH partnering with Delta for dental services?
If you have tricare, are you eligible to receive APTC’s from the health connector?
I have a patient who is having his PT-1s denied, and the only reason I can think of is because he does not have a home address listed on his application? I have listed the hotel as his physical address, but now they are requesting proof of residency. Is there a better way to handle […]
If you have a part C plan and are a QMB, are you charged for the co-pays, or is this something that MH will pick up? A member I am working with got QMB status on 6/1, but her United healthcare part C plan didn’t end until 7/31. Is she responsible for the co-pays for […]
Can someone point me in the direction of where I can find guidance on the cancellation dates for MH members when they are moving over the the health connector? I vaguely remember it being in some type of training.
I am looking for clarification on HSN coverage after someone’s connector plan starts. Does HSN cover the co-pays associated with visits for the 90 days, or does HSN essentially stop after plan start date because it is superseded by the HC plan? Is there a place to see when the 90-day HSN stops? Our EMR […]