Here’s how to avoid a MassHealth coverage gap, visiting experts advise [masslive.com]

SPRINGFIELD — Don’t delay responding to communication from MassHealth if you want to keep your coverage, health insurance leaders visiting Springfield advised Wednesday.

Representatives from MassHealth, Massachusetts Health Connector, Health Care For All and local officials gathered at the State Office Building on Dwight Street to discuss with residents and their advocates the ongoing redetermination process and detail efforts in Western Massachusetts to ensure that enrollees can stay covered.

Since the outset of the pandemic in March 2020, and in response to the Families First Coronavirus Response Act, MassHealth suspended eligibility redeterminations and continued members’ health care coverage throughout the entire public health emergency.

On Monday, Gov. Maura T. Healey told The Republican that redeterminations have returned, now that the pandemic is over. The eligibility reassessments began in April and will continue throughout 2024.

Redetermination “basically means realigning people with other forms of insurance,” Healey said.

“The fact is some will move off MassHealth,” Healey said. “2.3 million residents are on MassHealth, about a third of the state’s population of nearly 7 million. So, there are going to be a few hundred thousand who are going to move off MassHealth.”

An estimated 2.4 million members could go through the redetermination process, and the goal is to preserve the state’s universal health care, said MassHealth Assistant Secretary Mike Levine. About 300,000 people could lose coverage, but it is too soon to say, he said.

About 97% of residents in the commonwealth have health insurance because state leaders have championed it, noted Audrey Morse Gasteier, Massachusetts Health Connector executive director.

“We don’t want to lose ground during the redetermination process,” said Maria Gonzalez Albuixech, Health Care For All director of communications and community engagement.

MassHealth and its partners are working on the ground in 15 communities that have the greatest number of members enrolled to inform them about the redetermination process. They’re able to communicate with commonwealth residents in nine different languages.

Teams, or “navigators,” will be going door-to-door with the campaign message to ensure support is provided in the most vulnerable communities, such as older adults, refugees and people experiencing homelessness or with disabilities. According to Jason Lefferts, a Health Connector spokesperson, the real focus will be on having navigators and other assisters on hand to help people who need coverage the most.

“It can be anything from answering a few questions, updating an account, to doing an entire application,” Lefferts said.

In addition, 18 enrollment events will take place throughout the state, including one on June 17 at the Basketball Hall of Fame in Springfield from 12 to 4 p.m. For members who come, there will be lunch, activities and free entry into the Basketball Hall of Fame.

5 must-know tips to keep your MassHealth coverage

To avoid gaps in coverage, state health insurance experts offered these recommendations for any MassHealth member who remains uncertain about their redetermination:

1. Update your information

The state advises all MassHealth members to update their personal information either online or over the phone.

2. Look for MassHealth messages

Keep an eye out for any correspondence from MassHealth via mail, email, text or calls, say health insurance advocates. Members also should look for a blue envelope, open and read it. Do not throw it away thinking that you already have coverage, experts warn.

3. Respond to mailing

Open all envelopes mailed from MassHealth, and follow the directions provided, advocates say. Action is required to preserve the coverage members have or to transition to another program.

If members miss the blue envelope and lose coverage, they will get a 14-day letter at that time, and they can still call the office to start the redetermination process.

If members miss the 14-day period, there is another 90-day period that insurance can be reinstated if they call.

4. If people no longer qualify, there are other supports

If a member has found themselves slipping through the cracks, there is still opportunities to get coverage.

Members who no longer qualify for MassHealth can still get assistance through the Health Connector for finding Medicaid coverage, for chronic care, prescriptions, insurance subsidies, lower premiums, deductibles and co-payments, or assistance with enrollment in employer insurance. New residents can also get help with applying for the first time.

5. You can always reach out

For more information, visit MAHealthconnector.org or call 877-623-6765 (TTY 877-623-7773).

Reporter Jim Kinney contributed to this report.

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