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, […]
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 […]
Hi there, A client of mine was downgraded from MH standard to senior buy-in and revs shows this took place on 8/18/2022. It is my understanding that this should not have happened under the updated guidance for the PHE. Is that accurate? Thanks!
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.
It seems every time lately I enroll someone into Tufts Together online thru the MH choices enrollment site, the incorrect physician is added. I have copies of the confirmations with the physician I added, yet nearly each one gets enrolled in a random physician.
Hello! The new eligibility responses in MMIS show patients having Standard and Limited on the same day. I thought it could be a pregnant patient, but that is not the case. Any reason it is showing like this? Is this correct, patients now can have both eligibilities? How can that be? and should we be […]
I have a client over 65, She has Medicare A&B with the Senior Buy In. She has no problem getting the coinsurance and deduct paid by her Mass doctors. However, she goes to a doctor in Rhode Island, 3 times a year. They always bill her the balance after Medicare. Her Medicare summary clearly […]
If a client has a $3,000 esi deductible and a $1,200 deductible for partial HSN do they need to pay both deductibles before their HSN eligibility begins? Mr. Smith has a $9,000 procedure and pays his $3,000 deductible. Now he has full coverage from his esi. Is the $1,200 partial HSN deductible considered payed too? […]
Hi, I have a client who just turned 65 and enrolled in Medicare. He was previously on MassHealth CarePlus. The CarePlus followed him as a secondary to his Medicare. The client emailed me that he went for a doctor’s appointment and his specialist told him his MassHealth is inactive. I called an spoke with a […]
Hi fellow Navigators, My name is Buliah Mae, Lead Navigator for the Hilltown Community Health Centers. Our three-person team is currently considering new ways to track our monthly report data and are interested in how other health centers do this. What are the pros and cons? Is the program web based? Is the program customized […]