Hello, We have a patient who opted out of Part B, but now wants to get it back. He understands the Part B penalty and is okay with paying an increased amount. When we call Medicare to enroll him, they said he has to go through Social Security. When we call Social Security, they say […]
Hi all, Is eligibility for APTCs and ConnectorCare through the Health Connector determined using FPLs from the previous year or from the current year? For example, is the 2020 FPL being used to determine 2021 eligibility, and was the 2019 FPL used to determine 2020 eligibility? Thanks!
We are being told that masshealth is no longer accepting 2019 tax returns for self-employed individuals as proof of income. Is this true?
Happy Almost New Year! I’ve noticed that there are some inconsistencies in documents being processed when uploaded to a member’s account. Some are being processed faster than others. I remember MH letting us know that processing time was about 15-30 min, but that doesn’t seem to be true for all members. Does anyone have insight […]
Hi all, Two questions in a row, sorry! I have a client who was on MassHealth Standard but who had a big jump in income in the past year. He’s now eligible for ConnectorCare 3B. He doesn’t have many health needs, but he sees one provider weekly who is in-network with one of the CC […]
Over the past few weeks, I’ve experienced problems with incorrect eligibility determinations for members renewing their Health Connector coverage for 2021. As instructed, I enter any changes to income, check off whether they have filed taxes and reconciled APTC’s for the prior year, answer that they do not have affordable insurance offered through an employer, […]
I regularly enroll people in OneCare. For the first time this month, my enrollments are being blocked by Part D enrollment. This makes absolutely no sense to me. People are supposed to drop their Part D (access to all medications) to enroll in OneCare? I am making as much noise as possible about this barrier, […]
I have a client that was bumpted from Buy In to Senior Buy In. It is my understanding that Sr Buy in pays the Medicare deductibles and 20% coinsurance as well as the Part B premium. She is a transplant candidate and the other hospital told her that Sr Buy In will not pay the […]
Hi all, At the 9/17/20 Assisters conference call on Health Connector Redeterminations and Renewals, someone brought up the National FEMA SEP. The FEMA SEP allows people to enroll in coverage through HealthCare.gov if they lost qualifying coverage more than 60 days ago but missed their chance to enroll. The Health Connector rep stated that the […]
Hi all, Wanting to clarify, would MassHealth cover a non-emergency ambulance ride for a COVID+ patient? I know that they released separate billing codes for COVID+ patients and those with CarePlus or Standard are having these rides covered, but I can’t seem to figure out if folks who only have Limited could also have their […]