1. What is the Affordable Care Act (ACA)?
  2. How does the ACA affect Massachusetts?
  3. What is the Massachusetts Health Connector?
  4. What is MassHealth?
  5. Will all MassHealth members’ coverage change on January 1, 2014?
  6. What new programs will MassHealth have in 2014?
  7. How will the changes affect people who qualify for the Health Safety Net now?
  8. How does the ACA affect MassHealth providers?
  9. Where can people get more information or help?

 


 

  1. What is the Affordable Care Act (ACA)?

    The ACA is a federal health care law signed in 2010 that is designed to make it possible for millions of Americans to get affordable health insurance. It also changes some of the ways that health insurance worked previously and creates new protections for consumers who need health insurance.

    You can learn more about the ACA at www.healthcare.gov.


    Back to questions.
     

     

  2. How does the ACA affect Massachusetts?

    Massachusetts laid the groundwork for national health care reform with its landmark state health care reform in 2006. The new national law strengthens and even expands upon the health care improvements that Massachusetts residents have enjoyed since health reform was implemented here. The ACA provides help for people with low and middle income to afford health insurance, establishes an online health insurance marketplace, and requires that most adults have health insurance. The ACA also provides new ways for individuals, families, and businesses to find affordable health insurance and get help paying for it.
     



    Back to questions.

 

  1. What is the Massachusetts Health Connector?

    The Massachusetts Health Connector is our online health insurance marketplace at www.MAhealthconnector.org. There visitors can find and compare health plans, enroll in a plan, and find out if they qualify for help paying for health insurance.


    Back to questions.

     

  2. What is MassHealth?

    MassHealth is the name for the Medicaid program in Massachusetts. It provides health care coverage to qualified Massachusetts residents. Because of the ACA, more Massachusetts residents will qualify for MassHealth. Read the Member Booklet to learn more, or visit www.mass.gov/masshealth.


     Back to questions.

     

  3. Will all MassHealth members’ coverage change on January 1, 2014?

    a. No, not all MassHealth members’ coverage will change on January 1, 2014. In fact, about 80 percent of MassHealth members will have no change in their coverage as a result of the ACA. Those MassHealth members who are transitioning to new benefits will receive informational letters in November and December from MassHealth or the Health Connector. Most MassHealth members do not need to reapply for coverage. There are a couple of exceptions, noted below.

    Members who do not know their coverage type, can call MassHealth Customer Service at 1-800-841-2900.

    A member’s coverage will stay the same if the member is enrolled in one of the programs below, as long as the member still qualifies, with some exceptions noted below:

    1. MassHealth Standard

    2. MassHealth CommonHealth

    3. MassHealth Family Assistance
    Note: MassHealth Family Assistance members who are HIV positive and earn up to 133% of the federal poverty level will move to MassHealth Standard.

    4. MassHealth Limited

    5. Children’s Medical Security Plan (CMSP)
    Note: Members who may qualify for help paying for new insurance plans with better benefits will receive an informational letter from the Health Connector asking them to reapply. If a member or a member’s child qualifies for health insurance through the Health Connector but does not enroll, the member may have to pay a tax penalty.

    The four coverage types below will end on December 31, 2013, and members will be transitioned to a new coverage type with the same or better benefits. Most members will be enrolled automatically in their new coverage, but some will have to reapply.

    Basic
    New coverage type: Most MassHealth Basic members will move to MassHealth Care Plus, a new MassHealth coverage type. Some MassHealth Basic members will move to MassHealth Standard, if they are 19 or 20 years old or get services from the Department of Mental Health. Members will be enrolled automatically in their new coverage and do not have to reapply.

    Essential
    New coverage type: Most MassHealth Essential members will move to MassHealth CarePlus, a new MassHealth coverage type. MassHealth Essential members who are 19 or 20 years old will move to MassHealth Standard. MassHealth Essential members who have a special immigration status and are either disabled or over age 65 will move to MassHealth Family Assistance. Members will be enrolled automatically in their new coverage and do not have to reapply.

    Healthy Start
    Healthy Start members will move to MassHealth Standard until the end of their pregnancy plus 60 days. Members will be enrolled automatically in their new coverage and do not have to reapply.

    Insurance Partnership
    Employees of small businesses who are currently getting help with their insurance premiums through the Insurance Partnership will be eligible for continued help with the costs of health insurance through MassHealth or the Health Connector. The MassHealth or Health Connector benefit they receive depends on their income and family circumstances. Most members will be automatically put into a MassHealth program, but some members will need to reapply. Former Insurance Partnership members who don’t qualify for other MassHealth programs or subsidies through the Health Connector may qualify for the new Small Business Employee Premium Assistance program.


    Back to questions.
     

     

  4. What new programs will MassHealth have in 2014?

    MassHealth will offer two new programs in 2014:

    MassHealth CarePlus is a new benefit plan for adults 21 to 64 years old whose income is at or below 133% of the federal poverty level, and who do not qualify for MassHealth Standard. MassHealth CarePlus will offer a wide range of health benefits. Most people who will qualify for MassHealth CarePlus are now in MassHealth Essential, MassHealth Basic, Commonwealth Care, or the Medical Security Plan. Others who may qualify for CarePlus are currently uninsured.

    Small Business Employee Premium Assistance is a new program that helps pay health insurance costs for people who can get qualifying employer-sponsored insurance and who work for employers with 50 or fewer full-time employees. The individual must not qualify for any other MassHealth coverage or subsidies through the Health Connector. This program provides coverage continuity for former Insurance Partnership members who do not qualify for other benefits through MassHealth or the Health Connector.

    Back to questions.
     

     

  5. How will the changes affect people who qualify for the Health Safety Net now?

    The Health Safety Net is not a health insurance plan. It pays hospitals and community health centers for health services provided to qualifying patients who have low income and are uninsured or underinsured. Many people who receive services paid for through the Health Safety Net did not qualify for MassHealth or Commonwealth Care before the ACA but will qualify now. To learn more about the Health Safety Net, visit Health Safety Net .

    Here’s what may happen to people who qualify for the Health Safety Net now:

    If they qualify, they may be automatically enrolled in MassHealth starting in January 2014. MassHealth will send letters in November and December 2013 to qualified individuals.

    If they qualify, they may be able to get help paying for a new insurance plan through the Massachusetts Health Connector. The Health Connector will send them information on how to apply for new benefits. If they do not apply, they will still qualify for the Health Safety Net at least until their next annual review, unless their circumstances change. However, they may have to pay a tax penalty for failing to get health insurance coverage that is available to them.
    Some people will not qualify for any new health insurance options in 2014. As long as they will still qualify for the Health Safety Net, they do not have to do anything.


    Back to questions.

     
     

  6. How does the ACA affect MassHealth providers?

    To learn about the effect of ACA on providers, please visit the MassHealth ACA Provider website at: www.mass.gov/masshealth/aca.

    Back to questions.
     


  7. Where can people get more information or help?

    Call MassHealth Customer Service: 1-800-841-2900

    Call the Massachusetts Health Connector: 1-877 MA ENROLL (1-877-623-6765) or TTY 1-877-623-7773 or visit the Connector website at: www.MAhealthconnector.org.

    Visit the MassHealth website: www.mass.gov/masshealth.

    Visit the Health Safety Net website: www.mass.gov/chia .

    Visit the Commonwealth of Massachusetts federal health reform website: www.mass.gov/nationalhealthreform.

    Visit the Centers for Medicare and Medicaid Services, federal health reform website: www.healthcare.gov.

Back to questions.