Worried about losing your MassHealth coverage? Here is where you can get help in Berkshire County

Massachusetts Statehouse. Photo Courtesy of Wikimedia.

By Sydney Kodama

Boston University News Service

Berkshire County residents receiving large, light blue envelopes in the mail from MassHealth requiring them to respond to keep their coverage have a number of agencies ready to help them.

Starting last March, members of the state’s Medicaid program were notified they would have to fill out an application to reevaluate their eligibility. That was because the requirement for Massachusetts to provide continuous coverage, previously supported by the federal public health emergency, ended that month.

It’s the first time in three years residents can be disenrolled from MassHealth, said Jason Cuddihy, Advocacy for Access program manager.

“Everybody is now going through the renewal process, which was the case pre-COVID,” Cuddihy said. “It’s just that for three years, if you didn’t return the renewal, you weren’t terminated. If you returned the renewal but your income changed and you would have normally not been eligible, you still remain eligible. That’s not the case now.”

Organizations like Advocacy for Access can help Berkshire residents fill out their MassHealth eligibility forms. Even if the application deadline to keep their coverage passed, residents can still apply to be considered for reinstatement.

Lisa Jamros, regional SHINE Program director for Elder Services of Berkshire County, said MassHealth participants typically have 45 days to respond once they receive the light blue envelope. The response time can become 90 days if they must submit additional documents to hold onto their eligibility.

“MassHealth will work with them if they’re making an attempt to get it in,” she said.

Jamros emphasized the importance of MassHealth enrollees not ignoring the re-determination forms by recounting how a member lost their coverage and could not obtain insurance prior to a surgery.

She said the paperwork process is “a very stressful situation for people” and “can definitely have a negative impact on Berkshire County residents” when they do not receive or respond to the mail.

There is another state-backed option for people who lose MassHealth.

The State House News Service has reported that the Massachusetts Health Connector, created as part of the state’s 2006 health care reform law, has enrolled approximately 20 to 25 percent of former MassHealth members.

Cruz said as a patient navigator, he helps Berkshire residents with their applications for both MassHealth and the Connector, even if the MassHealth deadline has passed.

“They can always come to us, and we can help them actually reapply, renew their insurance, and they can gain that insurance coverage,” Cruz said. “A lot of those people do, even though they didn’t apply to renew their insurance, it’s just a call away from us so they can reactivate their coverage again.”

Cruz said CHP Berkshires did see a decrease from last year in the number of their patients covered by MassHealth. But he added that this change is likely due largely to them now being able to enroll in their employer’s insurance.

Cuddihy said that any higher number of residents being found ineligible for MassHealth is likely “due to the fact there’s now more people on MassHealth than has ever been on MassHealth in the history of the program by several hundred thousand.”

Over two million people were enrolled in MassHealth as of December. More than 19,000 of those members regained MassHealth coverage after losing it earlier, according to the MassHealth redetermination dashboard.

To avoid losing coverage, Cuddihy said, residents also have to directly tell MassHealth if they moved since the start of the COVID-19 pandemic and have not received their redetermination forms.

“There is some additional confusion as to ‘why am I no longer eligible now’ when things have changed, it’s been a couple years since things have changed,” Cuddihy said.

“Even if someone is not eligible for MassHealth now, there’s still the state’s subsidized connected care plan where someone can get very comprehensive coverage for fairly low cost, depending on what their income is.”

This story originally appeared in The Berkshire Eagle.

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