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MassHealth's Updated Notification of Birth Process

December 29, 2020

In order to complete enrollment for newborn children of MassHealth enrollees into a MassHealth health plan in a timely manner, we want to prepare you for some upcoming changes.  The purpose of the changes is to ensure that eligible newborn children of MassHealth enrollees are placed into the proper health plan and that all information is provided timely to MassHealth.

Starting January 1, 2021, MassHealth will make the following changes to improve the member experience related to the enrollment of newborns. These changes include:

1. Revised Notification of Birth (NOB) form

  • Two new fields in the, paper (NOB-1) and electronic (eNOB), Notification of Birth form will let parents or guardians enter selections for health plan and primary care provider (PCP) enrollment for the newborn.
  • A field will be added to indicate whether the mother is eligible for or enrolled in ConnectorCare.
  • Forms with "Baby Boy" or "Baby Girl" in the place of the name will not be processed starting January 1, 2021.
  • NOBs should be submitted to MassHealth as soon as possible after birth, no later than 10 days after birth whenever possible. 

2. Changes to MassHealth managed care plan enrollment process for newborns

  • Once a completed NOB form is received, the eligibility information of the newborn is typically added into the MassHealth Eligibility System within one business day and will be retroactive to the date of birth. Managed care enrollment information is added into the MassHealth system once eligibility is established and will take effect prospectively.
  • Starting January 1, 2021, parents or guardians will have an opportunity to select a health plan and PCP for their child at the time eligibility is established through the NOB form. If the parent or guardian does not select a plan on the form, the newborn will remain in Fee for Service (FFS) status for up to 14 days after the NOB is processed.
  • If the parent or guardian does not make a voluntary managed care selection within 14 days after eligibility was established, MassHealth will automatically assign the child to a managed care plan. MassHealth will take the following into account when assigning the child to a MassHealth health plan:
    • If the child has an older sibling currently enrolled in a MassHealth health plan, the child will be assigned to the same plan as their next oldest sibling.
    • If there are no older siblings currently enrolled in a MassHealth health plan, the child will be enrolled in the same health plan as their parent or guardian.
    • If assignment based on the next oldest sibling or the head of household does not result in a health plan enrollment for the child, the child will be automatically assigned to a MassHealth health plan in their geographic area.
    • Reminder: Health plan and PCP for newborns may be switched at any time before their first birthday.

For more information related to the updated NOB process, please review the MassHealth All Provider Bulletin 305: Policies and Procedures for Newborn Members: Eligibility, Enrollment, and Payment.  

Questions can be sent to providersupport@mahealth.net or call MassHealth at  1-800-841-2900.  Acute inpatient hospitals can reach out to Sam Evans at Samuel.evans@mass.gov for more information about how to electronically submit the NOBs.

For newborns eligible for MassHealth, new parents or guardians are encouraged to choose a health plan and primary care provider (PCP) for their child. In cases where a health plan or PCP enrollment was NOT communicated to MassHealth on the NOB form, below are steps new parents or guardians can take to choose a health plan for their newborn:

STEP 1: CHOOSE a PCP and Plan.

  • Look for a plan that has the doctors, specialists, behavioral health providers, and hospitals that are most important to them.
    • If they know the pediatric provider they want, they should visit www.masshealthchoices.com, call the provider's office, or the MassHealth Customer Service Center, to find out which MassHealth plan(s) the provider accepts and then go to STEP 2 to enroll.
    • If they have not selected a pediatric provider, they can learn about health plans available in their area - as well as information on providers - by reading the Enrollment Guide, which was included in their  enrollment package. They can also find information at www.masshealthchoices.com
  • After they choose, they should enroll their newborn in that health plan and select the newborn's PCP.


STEP 2: ENROLL in one of these three easy ways.

  • Call a MassHealth customer service representative at (800) 841-2900, Monday through Friday, 8 a.m. to 5 p.m. For persons with partial or total hearing loss, please call TTY at (800) 497-4648.
  • Fill out the Health Plan Enrollment Form that came in their enrollment package and mail it in the enclosed envelope to the address written on the form.