Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	
	MassHealth
	Long Term Care Facility Bulletin 83
	April 2003

	TO:	Nursing Facilities, Chronic Disease and Rehabilitation Inpatient Hospitals, and Rest Homes Participating in MassHealth

	FROM:	Douglas S. Brown, Acting Commissioner

	RE:	Medex Premium Rate Increase

Background	Blue Cross and Blue Shield of Massachusetts has received approval from the Division of Insurance to increase premium rates for all of its nongroup Medex plans:  Medex Gold, Medex Silver, Medex Standard, Medex Basic, Medex Bronze, and Medex Core, effective May 1, 2003.

Rate Changes	The Medex plans, old quarterly rates, new quarterly rates, and new monthly premiums appear in the chart below.  The new monthly premium is the amount allowed as a patient-paid amount (PPA) deduction.  Fees for special billing arrangements that cause a premium to exceed these amounts are not allowable PPA deductions.

Medex Plan	Old Quarterly Rate	New Quarterly Rate	New Monthly Premium	
Gold	$1,130.76	$1,242.69	$414.23	
Silver	$   880.47	$	967.62	$322.54	
Standard	$   833.91	$	916.44	$305.48	
Basic	$   564.99	$	620.91	$206.97	
Bronze	$   371.46	$	372.24	$124.08	
Core	$   198.96	$	217.68	     $ 72.56	

PPA Adjustments	Although the rate increase is not effective until May 1, 2003, the Division will allow the higher premium deduction for the PPA calculation as of April 1, 2003.  The Division updated its computer system with the increased rates and recalculated PPAs for all affected long-term-care Medex members, effective April 1, 2003.  During the month of April 2003, system-generated notices containing information about the new PPAs will be mailed to affected long-term-care members, conservators, and nursing facilities.

			

Questions	Questions about information in this bulletin should be directed as follows:
•	for claims issues:  please call MassHealth Provider Services at 617-628-4141 or 1-800-325-5231; or
•	for questions about a member’s health insurance, including Medex, please call the MassHealth Enrollment Center.