Health Insurance Help (Mass Health)

Submitted by b-my-galentine t3_11462tc in massachusetts

Hi friends,

I have been on a connector care plan for the past two years. It is tufts health direct. recently I started school, so my income went down as I am now on part-time hours. I got a notice in the mail that my connector care 2b plan was being canceled and I would be enrolled in MassHealth. I really like my connector care plan and was on a 2b plan. Is there any way I can keep the plan or will I have to enroll in Mass Health?

I want to stay on the plan because I jumped through so many hoops to get certain medications covered and providers covered and really don't want to have to go through the prior authorization documentation all over again. I truly don't mind paying the premium as it is very low, I just want to keep the plan.

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Thank you all,

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Comments

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Thisbymaster t1_j8urhpf wrote

Masshealth is way better than any other health insurance offered anywhere.

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b-my-galentine OP t1_j8uwyxj wrote

the more I look at it the more it seems like its the same as my connector care plan except cheaper. I had tifts health direct and this is tufts health together

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KinkyKankles t1_j8uz963 wrote

I have Tufts health together through MassHealth and have had nothing but good experiences with it.

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b-my-galentine OP t1_j8v82vt wrote

I looked up all my providers and they are all covered on both plans. Do you need a referral on tufts health together? Any caps on specialist or mental health visits?

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RiverRATT65 t1_j8uj6sp wrote

You can have mass health and probably will pay a small amount for it every month. It depends on your income level. Standard mass health pretty much covers most medications and you might have a small co pay. There are different mass health plans like the ones on the connector. Mass health will let you know which ones are available to you and if you have a small insurance payment every month. As far as mass health taking your assets, please look up the information on the mass health website. I doubt you have much to worry about. Edit here it is MassHealth may recover assets from:

Any members who received care after age 55 or older, or

Members of any age who were permanently in a long-term care or other medical facility (like a nursing home

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legitcopp3rmerchant t1_j8urslt wrote

Sounds like you were auto-enrolled into Mass Health and thats why your connector care was canceled. You can call connectorcare (best of luck to you) and inquire about attempting to recover the plan. But I would recommend going down to Advocacy for Health programs and speak with someone. They are usually affiliated with hospitals and have people certified in navigating health connector and mass health.

I was able to cancel my health connector plan, of 6 years, this month because I finally have a full time job with insurance benefits (hurray!) And I always spoke with an adocate to make sure I was in the right bracket.

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Brian-OBlivion t1_j8w4ku9 wrote

I've actually had decent luck calling them recently. Shorter wait and actually helpful. I remember 10 years ago (when I first signed up) it being a total shitshow.

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dhjsjakansnjsjshs t1_j8vhr4v wrote

Mass health has significantly more protections for the patient than a simple connector plan does. Most types of healthcare do not even require a copay or referral with mass health. There are some prior auth requirements that your providers will need to deal with but that's not your problem. If mass health denies coverage most of the time the provider is obligated to eat the cost of your care!

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WinstonGreyCat t1_j8w8bu3 wrote

You can look up all medications online ans find out if a prior authorization will need to he done. Google masshealth prior authorization drug list. The PA forms are very clear about what will qualify or not.

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Quirky_Butterfly_946 t1_j8uhitc wrote

FYI, MassHealth will need to be repaid to the state from your estate upon death. So what you use for Masshealth will need to be paid back. It is the same with Medicaid too.

I know this is not part of your questions, of which I do not have any answers, but thought as a PSA, people should be aware that this is not free care.

People should know what their total indebtedness is if anyone wishes to leave any estate to their children/spouse. So if someone needs to go into a nursing home too, and have it paid for by Medicaid as the costs are insane, please know that when a person dies the state can take your assets like your home to cover what they paid to the nursing home.

People should be able to know what their cost load is so that if they want to pay it down while they are alive, they should be able to do that.

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WinsingtonIII t1_j8uqiap wrote

This is a confusing topic, but this comment is a bit misleading. MassHealth (which is the same thing as Medicaid, just the MA name for it) can only recover assets via estate recovery for two categories of members:

  • Any members who received care after age 55 or older, or

  • Members of any age who were permanently in a long-term care or other medical facility (like a nursing home).

MassHealth will also not pursue any estate recovery if the value of the member’s estate is $25,000 or less and there are various ways to get a hardship waiver as described here: https://www.mass.gov/info-details/massachusetts-medicaid-estate-recovery

It does not sound like OP is in permanent nursing care given they are actively in school and working. If they are under 55 they do not have anything to worry about at this point either.

My understanding is that the reason for the 55 cut off (though personally I think it should be 65) is that everyone over 65 is eligible for the federal >65 healthcare program Medicare anyways, so they really shouldn't be on MassHealth after 65 except in very specific circumstances, which generally pertain to accessing long-term care because for some reason Medicare doesn't cover long-term care. Which is ridiculous considering Medicare is the healthcare program for 65+, and most people in long-term care are 65+. I am not sure why the cutoff for estate recovery is 55 however, this is a federal cutoff that the state follows along with.

The 2nd group of people who were permanently in a long-term care facility are primarily over 65 anyways, there are very, very few people under 65, or especially under 55, who are permanently in long-term care facilities.

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