MassHealth Insurance Program to Begin New Eligibility Determination

MassHealth Insurance Program to Begin New Eligibility Determination

MassHealth, the state health insurance program, is expected to begin its process of reconsideration of eligibility effective April 1, effectively ending a pandemic-Era policy that suspended the annual review of people’s eligibility for public health coverage.

THE Administration Healey estimates mass health enrollment will grow from 2.3 million people to about 1.9 million people during the one-year process, freeing up $1.9 billion for the state budget for fiscal year 2024.

With nearly 400,000 people currently enrolled in MassHealth expected to lose coverage, according to Healey administration estimates, public health officials and lawmakers say the state is ready.

During a Joint Ways and Means Committee hearing on health care investments in Governor Maura Healey’s fiscal year 2024 budget proposal, Assistant Secretary for MassHealth Michael Levine said the public insurance program is preparing for the onslaught of labor by verifying the eligibility of those 2.3 million enrollees and helping those no longer eligible to switch to other coverage.

As the state grapples with a labor shortage, MassHealth hopes to double the capacity of its call centers over the next two months to determine eligibility.

MassHealth Bolsters Staff to Help Address New Eligibility Determination

The agency is increasing its workforce at all levels, Levine said, including doubling the number of customer service representatives in call centers to 320, hiring 100 more workers to determine eligibility, 80 to 100 temporary employees to process applications and using grants to increase the workforce of Certified Application Advisors.

Levine said MassHealth is looking to make the application process easier and to remain transparent throughout the redetermination process.

The agency has reduced the long MassHealth application by about 75% for applicants over 65, Levine said, and next month it will begin allowing seniors to apply over the phone. These calls will take 90 to 120 minutes, “but it’s a start” to make the process more accessible, he said.

Starting in May, MassHealth officials will begin releasing a public dashboard that will show where people who lose MassHealth coverage live, their demographics, and the reasons for losing coverage.

Senator Julian CyrD-Truro said about half of MassHealth’s membership should be automatically renewed.

“There’s no need to panic, there are windows built into the review process so people don’t lose coverage immediately,” Cyr said.

Maria Gonzalez, the MassHealth Redetermination Campaign Director at Health care for alla nonprofit advocacy group focused on promoting health equity and equitable access to medical coverage, said the goal is not to kick anyone out of insurance.

“The message really is that even though the health insurance landscape is extremely complicated to navigate, Massachusetts has a lot of programs and a lot of opportunities for people to have access to health insurance,” Gonzalez said. “Until they are renewed, until they complete the redetermination process, they will be covered by MassHealth.”

For those not eligible for auto-renewal, Gonzalez said they should update their contact information via mass health and be on the lookout blue envelopes arriving in the mail containing instructions for reconsideration.

“After they get the blue envelope, they’ll have 45 days to respond, and that’s when they really need to act,” she said. “But I don’t want people to worry at the moment until they get this letter, at the moment what people need to do is really update the information so that they can receive the letter, and they can act once they have received the letter. ”

There are skeptics about hiring MassHealth’s call center.

After personal and professional challenges navigating the MassHealth system, State Representative Ann-Margaret Ferrante of Gloucester said she was concerned that the elderly and disabled would find it difficult to navigate the process of redetermination, regardless of new hires.

“I’m not buying for a second that 150 people are going to help the situation,” Ferrante said during the hearing. “As someone who has a family member who is blind, that happens to be my mother… Please call her when she has to fill out her re-examination paperwork. The mail is difficult because she is blind. And Unless someone accesses the mailbox for her and knows something is up, she may not receive this document.”

On the Cape, Ami Bowen, Vice President of Marketing and Community Engagement at Port Health Servicessaid community health centers like the Hyannis facility the company operates will play a key role in the new determination.

“Health insurance, in general, is a really intimidating and difficult subject for everyone,” she said. “So I think one thing that all community health centers are working on right now is just making sure our patients and community members know there are resources available.”

Community health centers, Bowen said, work primarily with low-to-moderate income patients, many of whom are currently covered by public health plans. And while the prospect of losing coverage is of great concern to patients, she said the options in the event they are deemed ineligible for MassHealth are solid.

“We understand that the thought of losing access to health care is extremely frightening for people,” Bowen said. “If it is determined that they are no longer eligible for income, there are options for health insurance and there is support to identify what those options are.”

Senator Cyr: Use the Massachusetts Health Connector to find coverage

One of these tools is the Massachusetts Health Connectorsaid Cyr.

“Many people who will be deemed ineligible for MassHealth will likely be eligible for subsidized health insurance coverage through the Health Connector,” Cyr said. “And to that end, the Health Connector is holding a special registration period from April to November, and they will be increasing the public information campaign.” offers milestones for current MassHealth members

  • Update your contact information. Make sure MassHealth has your most up-to-date address, phone number, and email so you don’t miss important information and notices from MassHealth.
  • Report any change of household. These include a new job, a new address, a change in income, disability status or pregnancy.
  • Create an MA login account. An MA login account is the fastest way to renew your MassHealth and Health Connector coverage, update your information, and notify your household of changes. Current members under the age of 65 can create an account by following the link provided on the back of your MassHealth reviews or by visiting
  • Read all messages from MassHealth. MassHealth will mail you information about your health benefits that may require you to take steps to maintain your current coverage. Look for a blue envelope in the mail and write down important deadlines.

Additional tips:

If you think you are no longer eligible for MassHealth, other health coverage options are available, such as an affordable plan through the MA Health Connector.

Members can visit or call customer service at 1-877-MA ENROLL (1-877-623-7773) to learn more or to sign up for a plan.

Loss of MassHealth coverage is a Qualifying Life Event (QLE), which allows members to enroll in a plan through the Health Connector outside of the regular open enrollment period.

State House News Service material was used in this report

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