Hi all, MassHealth published a transcript of the Q&A from webinar about 2023 renewals and I want to ask your thoughts about the answer to the final question about HSN eligibility after losing MassHealth. Doc is located here: Doc is located here Question: “Some members will lose coverage due to ineligibility and will enroll in […]
Hi all, Can someone explain to me whether the rules for completing an NDF differ between MassHealth and the Health Connector? My understanding is that each Navigator needs to have their own completed NDF on file for any client they are representing. At the bottom of Page 2 of the NDF form under Can I […]
Hi, I have a client who is transgender and has not legally changed their name yet. However they use a different name than that on their social security card. I was able to use their *new* name on the application and list their old name (deadname) on the application under the “is this the name […]
Hi all, A bit of a detailed question, but does anyone have any insight into why MassHealth (and consequently the ACO plans) will not cover Ozempic for the use of weight loss? We have a few providers trying to prescribe it, but it is not covered by Medicaid yet is covered by private insurers. It […]
Hi all, Has anyone else seen a large increase in the number of patients who are enrolled in a Medicare Part C (Medicare Advantage) plan with WellCare? This has been happening for the last few months and when we ask patients, they seem to have no knowledge that they were enrolled. In some cases, it […]
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 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 […]
Hello Do we have 2022 FPLs? I don’t think I have received an email with the new ones yet. Happy New Year!
Hi all, Is anyone else experiencing similar situations? I have called several times for complicated cases that are still pending after weeks and months of asking to resolve them but when the HC rep would get stuck on what to say or do next, the call would just get disconnected “unexpectedly”. Other reps would just […]
Just reviewing the information about Next Renewal Date and it’s unclear as to what triggers these renewal dates. After looking at 3 different accounts, they all have renewal dates of “August 16, 2021” Is there a clearer reason for what determines the renewal date?