Other Subsidized Coverage, Health Care Reform

"Outreach & enrollment" means much more than putting up posters and helping people fill out MassHealth applications. Recently, over the course of a two hour appointment, my supervisor and I counseled one household on eleven different public health insurance, subsidy and care programs. We helped them file four separate applications to five different insurance programs, putting together a patchwork of care options to cover the hole left by the loss of employer-sponsored insurance.

The Qualifying Student Health Insurance Program (QSHIP) was set up to assist all individuals studying at colleges and universities in Massachusetts. However, with the creation of Health Care Reform, we are beginning to see more issues with these plans than before. For some students, the QSHIP programs create barriers that make it harder to access the care they need.

During the recent round of MassHealth Training Forum meetings, we were informed that commercial fishermen who are eligible for the Fishing Partnership Health Plan are not eligible for Commonwealth Care, because they are eligible for another state-subsidized health plan. The non-profit FPHP is a fine program offering a great benefit package through Harvard Pilgrim. The premium subsidy of approximately 50% is funded by a combination of federal, state and private benefactor dollars. This is a great option for many fishermen.

When one of our patients contacted me to tell me about his loss of the Commonwealth Care coverage that he'd had for about three months, I was surprised, to say the least. It was the middle of the month, so it wasn't a technical coverage cut-off; he had paid his premium, was undergoing treatment with the Visiting Nurses Association (VNA) and getting medication from the pharmacy. You can imagine his surprise, among other emotions, when the VNA and the pharmacy told him that his coverage was no longer active and they couldn't help him.