Automatic assignment (or “auto-assignment”) is the term MassHealth uses to describe how we automatically enroll someone in a One Care plan.

A MassHealth member may be automatically enrolled in a One Care plan if he or she meets all of the following:

  • Lives in Hampden, Hampshire, Suffolk, or Worcester County (counties with at least two One Care plans)
  • Received an enrollment packet mailing, and did not enroll or opt out
  • Is not enrolled in Medicare Advantage or PACE plan

Not everyone who meets this description will be automatically enrolled in a One Care plan.

MassHealth is planning three rounds of auto-assignment in the first year of One Care. Coverage will begin on January 1, 2014 for the first round, April 1, 2014 for the second round, and July 1, 2014 for the third round.

Before the coverage begins, MassHealth will send two notices to members who are being automatically enrolled in a One Care plan.

  1. The first notice will say which plan MassHealth has enrolled the member in, and the date when coverage will begin. The member will get this notice at least 60 days before the coverage would start.
  2. The second notice will remind members of the upcoming changes. The member will get this notice at least 30 days before the coverage would start.

Both notices will tell members how they can join a different One Care plan or keep their care the way it is now.

 

Auto-assignment Round Two – Coverage starts on April 1, 2014

At the end of January 2014, MassHealth mailed notices to some members letting them know that they have been automatically enrolled in a One Care plan.

If you received this notice, your coverage in that One Care plan will begin on April 1, 2014, unless you tell MassHealth that you would like to:

  • join a different One Care plan in your area; or
  • keep your Medicare and MassHealth like it is today.

If you tell MassHealth that you would like to keep your care the way it is now, MassHealth will not enroll you in a One Care plan now or at a later date. You can always choose to join a One Care plan at any time.

Copies of the notices MassHealth sent are posted below.

In addition to receiving auto-assignment notices, the 60-day mailing included an insert on One Care and Medicare Part D pdf format of One Care and Medicare Part D doc format of One Care and Medicare Part D to help members understand what auto-assignment in One Care means for their Part D coverage. MassHealth sent this information to address concerns that members are getting notices from their Part D plans about losing their current prescription drug coverage

Here are the key messages from the insert.

  • You may receive a notice from your Part D plan that it will no longer cover your drugs as of April 1.
  • You will continue to receive your prescription drug benefits from your current plan through March 31, 2014.
  • Your new prescription coverage from the One Care plan will start on April 1.
  • There will be no gap in your prescription drug coverage.
  • If you do not want to be in One Care, you may stay in your current prescription drug plan. You just need to call MassHealth before April 1.

Auto-assignment Round One – Coverage starts on January 1, 2014

On October 28, 2013, MassHealth mailed notices to some members letting them know that they have been automatically enrolled in one of the three One Care plans – Commonwealth Care Alliance, Fallon Total Care, or Network Health. 

Copies of the notices we sent are posted below.

 

If you have any questions, you can call:

MassHealth Customer Service

Monday – Friday 8 a.m.-5 p.m.
1-800-841-2900
TTY: 1-800-497-4648 (for people who are deaf, hard of hearing, or speech disabled)

 

MEDICARE

24 hours a day, 7 days a week
1-800-Medicare (1-800-633-4227)
TTY: 1-877-486-2048 (for people who are deaf, hard of hearing, or speech disabled)

 

One Care Ombudsman (OCO)

The One Care Ombudsman (OCO) is an independent program that helps individuals address concerns or conflicts that may interfere with their enrollment in One Care or their access to One Care benefits and services. The OCO works with MassHealth and each of the three One Care plans to help resolve concerns so that persons with disabilities can receive their health care benefits and exercise the rights to which they are entitled in One Care. OCO staff can work with you in person or over the phone.

Monday – Friday 8:30 a.m. - 4:30 p.m.
855-781-9898 (Toll Free)
MassRelay: dial 711 (for people who are deaf, hard of hearing, or speech disabled)

www.onecareombuds.org

 

SHINE (Serving the Health Insurance Needs of Everyone)

SHINE counselors can work with you and your caregivers to help you understand your options. They are trained to assist people who have Medicare and MassHealth and will provide impartial information about your health insurance options. SHINE counselors are available Monday–Friday, 9:00 a.m.–5:00 p.m. A counselor can work with you in person, by phone, or through e-mail.

Monday – Friday 9 a.m.-5 p.m.
1-800-243-4636
TTY: 1-800-872-0166 (for people who are deaf, hard of hearing, or speech disabled)


This information is provided by MassHealth.