Health Safety Net, Other Subsidized Coverage, Speaking up!

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.

"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 You can imagine his surprise, among other emotions, when the VNA and the pharmacy told him that his coverage was no longer active and they couldn't help him.