Financial hardship and Commonwealth Care

Premium waivers are available to current and former Commonwealth Care members, as well as to new applicants, who are facing "extreme financial hardship." This includes people who are in arrears with their Commonwealth Care coverage, who have lost their coverage due to lack of payment, or who are current with their payments but facing a hardship.

Situations that meet the Connector's definition of extreme financial hardship include expenses related to housing, changes in living situations or family responsibilities, fires, floods and other kinds of disasters, and debt incurred by specific medical expenses. Homelessness, eviction or foreclosure, or utility shutoff notices are grounds for requesting a premium waiver. Premium waivers are granted by the Connector and last for six months.

Clients must follow the Connector's steps to apply for a waiver:

• Waiver requests must be made first to the Connector call center. (Clients can be assisted through the 1-877-MA-ENROLL line by pressing "3" during the main menu to access the Commonwealth Care call center, and then continuing to select the menu option for "all other inquiries" until they reach a representative.)
• The call center will send out a waiver request form.
• Premium waivers or reductions may last for up to six months.
• Premium waivers or reductions may be applied to past due accounts.
• A new applicant must pay the first month's premium, regardless of hardship. If hardship is later determined, the premium will be waived.

Click here to view the premium waiver-reduction application (PDF).