Headline:
The MassHealth Eligibility Redeterminations process has begun and will continue through April 1, 2024. MassHealth Members should update their information and be aware of any notices from MassHealth via text, phone, email and mail.
Last-reviewed: 9am, May 26, 2023
Key Resources:
The Basics
- COVID-19 vaccines and testing will continue to be free for all MassHealth members, and some treatments will continue to be covered. Read more on MassHealth coverage and reimbursement policy updates re: COVID-19 after the PHE here.
- The Drug Enforcement Administration (DEA) is extending COVID-19 telemedicine flexibilities for prescribing controlled substances beyond the end of the public health emergency (May 11, 2023). The DEA had recently proposed rules for permanent telemedicine flexibilities with safeguards, but they are holding off for now. More information here.
- 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).
- 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.
The Breakdown
General
- MassHealth members may be contacted by text, email, robocall and/or mail regarding their renewal or with other important information about their health coverage. Members should lookout for communications from MassHealth starting April 1, 2023 through April 1, 2024. More information here.
- Care team members can educate MassHealth members and their teams to prepare for the end of continuous coverage requirements by sharing the MassHealth Eligibility Redetermination Outreach Toolkit. 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 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.
- 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.
- 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.
The Bottom Line
- Care teams can assist families and individuals through the MassHealth redetermination process using available information, tools and resources.
