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Updated MassHealth Response to Coronavirus Disease (COVID-19)

July 20, 2021
In response to the current Coronavirus Disease 2019 (COVID-19) public health national emergency, MassHealth implemented temporary changes in eligibility-related policies and processes to support the public health efforts to expedite access to necessary health care and maintain health care coverage for both new MassHealth applicants and existing members.
 
Upcoming Changes

The following are upcoming changes.
 
Flexibilities No Longer Supported:

Self-attestation for Eligibility Factors

Starting September 15, 2021, MassHealth will no longer accept self-attestation for certain eligibility factors that were temporarily allowed during the public health emergency, such as:
    • Residency
    • Disability
    • Income
    • Assets
 
Premium Hardship Waiver

Requests for Premium Hardship Waivers set in place for the PHE will no longer be accepted. On July 1st, MassHealth expanded the circumstances in which members can apply for a waiver or reduction of premiums for those experiencing an undue financial hardship:
    • longer timeframes
    • consideration of previous and prospective bills, and
    • expansion of the waiver to CommonHealth members.
 
MassHealth members can request a premium hardship waiver by completing and submitting the application of premium hardship waiver form.
 
Flexibilities that will Remain in Effect:

The following are temporary flexibilities that are not changing.
 
Maintaining MassHealth Coverage

MassHealth will maintain coverage for individuals who have comprehensive coverage, as defined by federal guidance, since March 18, 2020, during the COVID-19 federal public health emergency, and through the end of the month in which such federal public health emergency period ends. Coverage may still be ended for the following valid reasons:
    • requests termination of eligibility;
    • is no longer a resident of Massachusetts; or
    • is deceased.

Applicants and members should provide their most current information and report any changes to MassHealth to receive the best coverage. MassHealth has begun sending review forms to members in an effort to collect current information.

Access to Hospital-Determined Presumptive Eligibility (HPE)

In addition to individuals 65 years of age or younger, Hospital-Determined Presumptive Eligibility (HPE) will be available to individuals age 65 and older. Eligibility for HPE is based on the applicant’s self-attested responses to a limited set of questions in the HPE application. In addition, HPE will be made permanently available to children enrolled in the Children’s Health Insurance Program (CHIP), even after the end of COVID-19 public health emergency.
Note: HPE will remain a temporary benefit. Individuals determined eligible for HPE need to complete a full application and receive an eligibility determination.
 
One-time Deductible Hardship Waiver

Individuals who have been assessed a one-time deductible to establish eligibility for MassHealth CommonHealth may request a temporary waiver of the deductible due to financial hardship during the federal emergency period. 
 
Retroactive Eligibility for Individuals Younger than Age 65

Upon request, any individuals younger than age 65 who are applying for MassHealth on or after March 1, 2020, will have their coverage be retroactive, if they would have been eligible, as early as the first day of the third calendar month before the month of application, but no earlier than March 1, 2020.