Important Update on MassHealth (Medicaid) Re-determinations

MassHealth Logo

In January, Medicaid started to send out eligibility re-determination notices for MassHealth. These notices should not be ignored as the individual will face a gap in MassHealth coverage until they submit a new application.

Federal law requires that MassHealth renew member eligibility every 12 months. From this process MassHealth determines who remains eligible for the MassHealth programs.

There are 1.7 Million people on MassHealth. There are roughly 500,000 individuals who are persons with disabilities or seniors who need long term support or care services. The redetermination process for them has not changed and they should continue to respond to renewal letters they receive from MassHealth.

Because of systems problems last year, MassHealth renewals were interrupted for the remaining 1.2M members for quite some time.  MassHealth must now reach out to a large number of members to renew eligibility in 2015.

MassHealth is the key insurance program for long term support services for people with disabilities who need them in addition to the health, drug, and other coverages. The first phase of re-determination which began in January should barely affect our constituents and would focus on those receiving MassHealth Standard, CarePlus, or Family Assistance. Some families who receive the Standard insurance may have children with disabilities in the family or there could be adults who are not identified as having a disability.

This summer an additional 500,000 members including those with disabilities MAY receive notices. 200,000 MassHealth members will be exempted from these notices because they are eligible. These include those who are on SSI or the SNAP program (food stamps). Those on SSDI or Social Security through family members may get notices and of course some may get notices by accident. It’s not a perfect world.

We hope this clears up any confusion about what is going on in regard to the MassHealth re-determinations.

MassHealth has worked to ensure that members up for renewal, even if they have missed their deadline, have the support they need to renew and restore their benefits in a way that ensures continuity of care. If a member is in need of assistance or has missed their deadline they should contact MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648) or an Enrollment Assister which can be found at www.mahealthconnector.org/help-center.  When the MEC staff answers the phone, the caller needs to say, “here is my last name, please connect me to the case worker assigned”.

I want to thank Ken Smith and others at MassHealth for their assistance in clarifying the MassHealth re-determination process which is an annual one that may NOT have taken place in recent past. Thank you also to Vicky Pulos at Mass Law Reform. The Arc continues to appreciate the assistance of state and private organizations.

Leo Sarkissian Signature
Leo Sarkissian
The Arc of Massachusetts

Leave a Reply

Your email address will not be published. Required fields are marked *