Slide 1: One Care Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
March 8, 2022, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2: One Care Deemed Eligibility
•	As of April 2022, One Care enrollees who lose MassHealth Standard or CommonHealth for reasons that may be resolved will remain enrolled in their One Care plan for 2 (two) extra calendar months.
o	Loss of eligibility due to: changes in age or disability status, downgrades, financial and household issues, system transfers, and missing information would trigger a deemed period
o	Reasons such as: out of state moves, death, and voluntary disenrollment would continue to end enrollment in One Care at the end of the month eligibility closes.
•	One Care enrollees in a deemed period will continue to receive their One Care benefits through their plan
•	One Care enrollees would be disenrolled from their One Care plan if MassHealth eligibility is not restored by the end of the two-month deemed period
•	MassHealth and CMS expect to add language about Deemed Eligibility to the upcoming One Care contract amendment for 2022
Slide 3: Member Notices and Plan Support
Member Notices
•	MassHealth will send One Care enrollees who lose MassHealth eligibility and will have Deemed Eligibility a notice with the following information:
o	Date eligibility ended
o	End date of their deemed period
o	Contact information for their One Care plan, MassHealth Customer Service Center, and Medicare Customer Service Center
o	Medicare coverage options (if eligibility is not restored)
•	MassHealth will share data with One Care plans to identify members that have lost their MassHealth eligibility and are in a deemed period
Plan Support
•	One Care plans must support enrollees with redeterminations and resolving eligibility gaps. 
•	While plans should work with members to prevent eligibility disruptions, Deemed Eligibility will also provide extra time for enrollees to restore eligibility when it is lost for a resolvable reason.
Slide 4: One Care MassHealth + Medicare
Bringing your care together
VISIT US ONLINE

EMAIL US 
OneCare@mass.gov