Commonwealth Care, Health Safety Net, Speaking up!

The situation was all too familiar: A young woman and her father met with one of our Community Outreach Workers and asked how to sign up for health insurance. A quick check in My Account Page (MAP) found that her MassHealth Essential had ended mid-month because she had started a new part-time job. MAP also showed she was already Commonwealth Care eligible. The Outreach Worker explained how to enroll in Commonwealth Care and all of the benefits it would provide starting next month.

"Well, the problem is that she’s a heroin addict," the father said. "Her rehab clinic checks her insurance every day and won’t help her out until she gets her insurance back."

Enrollments usually slow down during the summertime, but this year, outreach workers are seeing increasing numbers of people needing help. At our July HAN meetings, we also had the opportunity to have some dialogue with Rebecca Balder and Carolyn Minkin of the Health Safety Net about upcoming changes.

"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.

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.