MassHealth requires members to enroll in health insurance they have access to that’s at no cost to them, including Medicare. This is because MassHealth is the payer of last resort and pays for health care and related services only when no other source of payment is available, except when required by federal law. Qualified Medicare… Continue Reading Enrolling Qualified Medicare Beneficiary (QMB) Members in Medicare
Applicants and members who receive affordable employer-sponsored insurance (ESI) are not eligible for Advanced Premium Tax Credits (APTCs). If an applicant or member is not offered ESI or is offered an unaffordable plan, they may be eligible for APTCs if they meet other eligibility requirements. The Health Connector verifies access to ESI by sending notices… Continue Reading Employee Sponsored Health Insurance Verification Effort
Health Connector Special Enrollment Period Effective Dates System and Process Update: When a member reports a change that opens a Special Enrollment Period (SEP) after the 23rd the month, the online application will now automatically offer an effective date option for the following month. Previously, when a member reported a move on 3/24, the earliest… Continue Reading Updates to Health Connector Special Enrollment Period Effective Dates and Updated Applications
As of January 27, 2025, MassHealth has issued a standing order for prenatal vitamins and a standing order for over-the-counter (OTC) oral hormonal birth control. MassHealth members and Health Safety Net (HSN) patients are now able to get these medications free-of-charge without a prescription from their prescriber. Learn more about the standing orders at Publications, Notices,… Continue Reading MassHealth Announcement: Standing Orders for Prenatal Vitamins, OTC Oral Hormonal Birth Control
Health Connector Member Tax Forms The Health Connector has completed the mailing of 1095-A tax forms for those members who had coverage in 2024. Mailed forms should be received during the week of February 3rd based on a member’s mailing preference. If a member selected paperless, they will get an email that informs them the 1095-A… Continue Reading Health Connector and MassHealth Tax Forms Mailed
