This summer, MassHealth starting enforcing the rule that households who hadn’t paid their premium bills for 60 days or more would lose their MassHealth or Children’s Medical Security Program (CMSP) coverage. Members of these households may be starting to show up at hospitals and health centers, they may have no coverage, and they can’t get the Health Safety Net.
MassHealth has indicated that people who are currently in a non-premium-paying category won’t be terminated and they don’t have to pay to get back on a plan.
We recently had a conversation about this on our email discussion list, and Brian Eno, an outreach worker at Healthy Connections in Orange, wrote:
Given Brian's client's income, she should be in a non-premium-paying category, so there must be some sort of error. Is this a case of confusing notices, or are people in a non-premium-paying category really being terminated? Has anyone else seen similar cases?
People who are still in a premium-paying category will have to pay the past due bill in order to get back on MassHealth or CMSP. They can call customer service at 1-800-841-2900 to arrange for a payment plan for up to 18 months so long as there is a $5/month minimum.
The Massachusetts Law Reform Institute’s one-page Billing Advocacy Tips (PDF) gives step-by-step instructions about what to do for people who are losing coverage for old MassHealth or CMSP bills, ways to maintain benefits, and when to appeal.
What are you seeing? Are people able to manage their past due payments OK, and stay on the plans they need?
I have a client
I have a client who her MH was stopped because of past due fees that she had from a year or two. She was on MH standard for after that and now she is back on family assistance and her services got cut off because of what she owed. She may not be eligible for MH standard anymore but her daughter has a condition that she has to go to Boston and without her MH this can be very costly.
Is this where "Medical Hardship" comes in?
Reading over the post another question came to mind. If MassHealth coverage is terminated for a family and HSN isn't available what does the family if they get bills during this period for emergency care? If HSN isn't available during this period, would Medical Hardship be unavailable too (given they're both programs of DHCFP)?
Plans Closed without much Warning
We've received a large number of notices for clients stating that they are being canceled for failure to pay premiums starting in July (not June as the Connector had stated).
Problem is, case managers do are not receiving the initial warning notices (or maybe the clients aren't either) and cases are being closed right away - without a chance for an outreach worker to intervene.
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