Health Insurance

Headline:

The Department of Public Health (DPH) issues an alert to clinicians and labs regarding novel strain of gonorrhea detected in Massachusetts.

Last-reviewed: 9am, Jan. 27, 2023

Key Resources:

The Basics

  • MA residents can apply for health insurance through the Massachusetts Health Connector during open enrollment from November 1 through January 23, 2023. Residents will face rising premiums, paying an average of 7.6 percent more in 2023.
  • DPH and the Massachusetts Chapter of the American Academy of Pediatrics issued recommendations (in Spanish here) for parents and families to prevent illness and stay healthy.
  • All people ages 6 months and older are encouraged to get the flu and COVID-19 vaccines and booster if they live, work, or study in MA. Vaccination clinics across the state are offering $75 gift cards to people ages 6 months and older who get a vaccine or updated bivalent COVID booster. Find additional information on mass.gov.
  • During the national COVID Public Health Emergency (PHE), MassHealth can only be terminated or reduced in very limited circumstances. The PHE is currently in effect through January 11, 2023. See the full guidance for details.
  • MassHealth Enrollment Centers are open for limited walk-in appointments. To set up an in-person appointment to discuss a health plan, use the appointment scheduler or call Customer Service (800-841-2900).
  • Although the US Supreme Court has overturned Roe v. Wade, eliminating the constitutional right to an abortion, abortion remains legal in Massachusetts. Governor Baker also signed legislation to further protect access to reproductive health care services in Massachusetts.
  • DPH has expanded its statewide public information campaign to raise awareness of the birth control benefits available under state law.
  • Many clinics are offering the mpox (formerly called monkeypox) vaccine to people who live or work in Massachusetts and meet the CDC’s eligibility criteria. Find more information here.
  • MA voters approved a new law that will require dental insurance companies to comply with new spending rules.

The Breakdown

General

  • DPH announced on January 19, 2023 that they detected a novel strain of gonorrhea in MA, which has been seen in other countries but not in the US. There are concerns regarding the strain’s resistance or reduced response to antibiotics. DPH has issued an alert, including recommendations, to clinicians and laboratories. More information here.
  • The bill for MassHealth’s extended 12-month postpartum coverage policy passed. MA legislature passed a bill to codify MassHealth Postpartum Coverage to extend postpartum coverage from 60 days to 12 months postpartum. Read HCFA’s press release here.
  • The US Department of Health and Human Services (HHS) expects the emergency declaration on mpox to end on January 31, 2023. Many MA clinics are offering the mpox (formerly called monkeypox) vaccine to people who live or work in Massachusetts and meet the CDC’s eligibility criteria. Find more information on mpox vaccination here.
  • The No Surprises Law requires many healthcare providers to give patients an up-front cost estimate of services. If the patient is later charged more than $400 above that estimate, they have an opportunity to file a dispute. There are also new limitations to out-of-network charges for some insured patients. For additional information, see the CMS consumer overview.
  • MassHealth covers some commonly used over-the-counter medications without prior authorization (e.g., aspirin, hydrogen peroxide, vitamin supplements). See the full list for details.
  • 2023 open enrollment through the MA Health Connector for insurance coverage began on November 1 and continues through January 23, 2023. Apply for insurance online through the Health Connector at www.MAhealthconnector.org or by calling 877-MA-ENROLL.
  • Thousands of Massachusetts residents who buy their health insurance through the Health Connector will face rising premiums, paying an average of 7.6 percent more in 2023. Learn more here.
  • For assistance navigating health insurance enrollment, getting medications or care covered, or finding affordable options, call the Health Care For All (HCFA) HelpLine at 800-272-4232 or submit an inquiry online. Assistance is available in English, Spanish, and Portuguese. Health Care For All’s Boston office has re-opened for in-person assistance.
  • If you have a problem with health insurance claims or medical bills, the Attorney General’s Health Care Division may be able to help. Call the helpline with questions or complaints at (888) 830-6277.
  • Veterans may be eligible for healthcare services through the VA. Use the VA website to navigate eligibility, benefits, and find providers. Those who received a less than honorable discharge can also use this Veterans Legal Services Guide.
  • On June 24, 2022, the Supreme Court overturned Roe v. Wade, holding that there is no federal constitutional right to an abortion. Abortion is still legal in Massachusetts. To see the effects of the SCOTUS decision on abortion laws and restrictions in specific states, check here.
  • On July 29, 2022, Governor Baker signed legislation to further protect access to reproductive health care services in Massachusetts. The law codifies several protections that Governor Baker put in place by Executive Order in June.
  • DPH has expanded its statewide public information campaign to raise awareness of the birth control benefits available under ACCESS, a state law that permits eligible people to get (1) a year’s supply of no-cost birth control with just one trip to the pharmacy; and (2) emergency contraception at no cost. Learn more here.
  • President Biden has signed two Executive Orders to protect women’s access to reproductive healthcare services. Read more on the new official government website reproductiverights.gov.
  • Over-the-counter hearing aids are now available to purchase online and in stores. Consumers do not need a medical exam, prescription or adjustment by an audiologist for this new category of hearing aid. Read the FDA news release here.
  • MA voters approved a new law that will require dental insurance companies to comply with new spending rules. The Question 2 ballot initiative, which passed by a wide margin, will require dental insurers to spend at least 83% of customer premiums on patient care and initiatives to improve quality of care rather than on business expenses.

COVID-19

  • The federal COVID public health emergency (PHE) is in effect through January 11, 2023 and is expected to be extended until April 2023. While the PHE is in place, continuous Medicaid coverage must be provided to enrollees.
  • MassHealth covers testing and treatment for COVID-19 as well as the COVID-19 vaccine and booster at no cost to members.
  • COVID-19 vaccines and the updated bivalent booster are available for people ages 6 months and older. Find a vaccine distribution location online or by calling Mass 2-1-1. Over 200 walk-in vaccination clinics across the state are offering $75 gift cards to people ages 6 months and older who get a COVID-19 vaccine or updated bivalent COVID booster.
  • Find additional information on COVID-19 vaccines and boosters on the COVID-19 Vaccine and Booster Information page.
  • COVID-19 test sites are available throughout the state. For additional information, visit the Find a COVID-19 Test page.
  • Households can order another 4 free rapid COVID-19 tests from COVIDtests.gov or by calling 1-800-232-0233. Most insurers are required to cover 8 at-home COVID-19 tests per month. Insurers can choose to have people pay up-front for tests and submit their receipt with a claim for reimbursement of up to $12.00 per test. Individuals should also check with their healthcare insurer for details. 
  • Free COVID-19 tests are available for MA residents who live or work in congregate care, have symptoms of COVID-19, or had recent contact with someone who tested positive for COVID-19. Individuals seeking a free at-home test should check the Labcorp website daily as availability is limited.
  • MassHealth and Health Safety Net members may qualify for curb-to-curb transportation to vaccine, booster, and testing appointments. Members should ask their doctor to submit a transportation request (i.e., a “PT-1 form”). If they have difficulty with the process, they can also call 1-800-841-2900.

The Bottom Line

  • Eligible individuals and families can enroll in free or reduced cost health and dental insurance.