Hello Loopers, In the bi-weekly MassHealth redetermination call there were a couple of eligibility policies announced: No pharmacy co-pays through 3/31/2024 For the under 65 the income attested to on the application will be considered reasonably compatible if within 20% of the income amount received from data sources Hospital determined-presumptive eligibility for the non-MAGI population […]
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 […]
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 […]
MassHealth released the MassHealth Redetermination Phase 2 Outreach Toolkit. You can read the full update from MassHealth here. You can download materials in 9 languages and share them with the members you work with! You can also have people check out the masshealthrenew.org page as well as HCFA’s page about the outreach campaign. -Hannah
Hello, I am wondering if anyone else is having issues with trying to maneuver through the enrollment form. I get to the Captcha question and put in the correct answer and it does not open up the save button to move to the next part of the form. It is making me second guess my […]
I have a client who has WellSense. There are only handful of primary care practices here on the Vineyard and only one takes either WellSense or PCC plan for MassHealth members. However, WellSense is not affiliated with Martha’s Vineyard Hospital (apparently it’s the same for PCC), the only provider on the island that does most […]
Many of our MassHealth clients over 55 received a letter about Estate Recovery. The question that they had is, even if they were locked in for the PHE would the Estate Recovery still be an issue. The policy only states that there were certain protections in place during COVID that have to do with estate […]
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, […]