Is anyone having issues with SACAs not being processed with the correct determination? I had a member fill out a new application. He would qualify for the Senior Buy In. He was denied. When we called to ask why? The customer service was saying that we are wrong and he is over income. I pointed […]
Hello Loopers, MassHealth posted an Eligibility Operations Memo regarding their policy updates returning to normal business operations. As of April 1, MassHealth is redetermining all members to ensure that they still qualify for their current benefits. Whenever possible, MassHealth will automatically process a member’s renewal by matching their information against state and federal data. If […]
Hi Loopers, MassHealth has provided updated guidance on working with MassHealth members post 4/1. To update contact information (address, phone number, email address) members/assisters should call MassHealth CST to make updates to prevent a new eligibility determination from the online system. If you are working with a member that wants to go ahead and be […]
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 […]
Hi Loopers, MassHealth posted an Eligibility Operations Memo on their approach to the end of continous coverage protections. Here is the memo. Key takeaways: Self-attestation for verifications is no longer accepted. Check out our ‘State Resources’ page for affidavits that are accepted. Waiver of the one-time deductible is no longer available Retroactive coverage for people […]
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 […]
We’ve seen an uptick in terminations with the reason, “you are not a Massachusetts resident”, where the member didn’t report an address change and was living in MA, and a MH rep. indicated the address MassHealth had changed the member’s address to was done using the address data provided by LexisNexis (at least on that […]
Hi all, Does anyone have best practices on how to get a duplicate MassHealth case closed? We have a patient with two open cases and it’s caused confusion in the past. When we call to ask that the other case be closed, we were told that they can’t close it and we just need to […]
Hi Loopers, MLRI has posted its 2023 FPL Table here and here is information about registering for our 2023 Health Access Training -in person or livestream–on Feb 27. Get a refresher on the Basics in the morning session & trouble shooting tips & an overview of what to expect in 2023 in the afternoon session, […]
Are the new updated rules for Commonhealth also applied to the over 65 population?