Posted on Apr 19, 2023

Masshealth coverage

The State Is Preparing for MassHealth Coverage Drop

As Massachusetts is preparing to drop hundreds of thousands of people from Medicaid MassHealth, government and community leaders are hoping for a smooth year-long process – but they are bracing for possible chaos.  

When the COVID-19 pandemic emergency hit, Massachusetts hit pause on the annual process of figuring out who continues to qualify for the state’s Medicaid program for low-income and disabled residents and the Children’s Health Insurance Program (CHIP). Using federal pandemic funding, coverage for MassHealth recipients was automatically extended during the global health crisis. 

April 1st marked the first time in three years that the state will begin combing through the insurance rolls to make sure that the only people receiving the coverage are those who are still eligible. That redetermination process needs to happen for some 2.3 million MassHealth recipients. Mike Levine, the assistant secretary for MassHealth, said in early March that about 300,000 people will likely lose their coverage and be redirected to other health care.

MassHealth officials will have 12 months to go through every member. “It’s a marathon, not a sprint,” Levine told legislators at a Joint Ways and Means Committee hearing in Arlington on Tuesday.

Those who still qualify for MassHealth and can be automatically renewed – about half of all recipients, officials estimate –  will get a letter in the mail letting them know that no action is needed. If MassHealth needs updated information, the member will receive a blue envelope in the mail. The member then has 45 days to respond by mail, email, or phone call, which could kick off another three month window to send more information if needed. These first few months are critical to get a sense of who will no longer qualify, Levine said. 

A public dashboard will let residents, community groups, health organizations, and lawmakers track the agency’s progress. MassHealth will launch the dashboard in May, Levine said. It will show anonymized data on where impacted MassHealth members live, their demographics, and why they are losing coverage.

Most of the enrollment growth during the pandemic came from groups of non-disabled adults and children who qualified purely for income reasons, Levine said, so the majority of people who will lose MassHealth will likely be earning slightly too much for the coverage now. Those members will probably still be eligible for subsidized insurance through the Health Connector, he said. 

Read the full news article by CommonWealth here.

We understand how difficult it can be to navigate the MassHealth system, and that's why we want to help. If you or someone you know is at risk of losing their Medicaid benefits, we urge you to reach out to our law firm for assistance. We can help draft the renewal application to ensure that all necessary information is included and that it is submitted on time.