Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth



		MassHealth
		Eligibility Letter 143
		March 1, 2006


TO:	MassHealth Staff

FROM:	Beth Waldman, Medicaid Director

RE:	MassHealth Essential:  Extension of Funding
	

An additional limited amount of funding is available for fiscal year 2006 to provide MassHealth Essential benefits to long-term unemployed applicants and members.

These regulations are being issued as emergency regulations and were effective October 1, 2005.


	MANUAL UPKEEP

Insert	Remove	Trans. By

505.007 (4 of 4)	505.007 (4 of 4)	E.L. 141



130 CMR:  DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 143


Rev. 10/01/05

	MASSHEALTH
	COVERAGE TYPES

Chapter
Page


505
505.007
 (4 of 4)

(D)  Funding.  State legislation does not provide funding for MassHealth Essential after June 30, 2006.  MassHealth Essential benefits will not be provided after June 30, 2006, unless a legislative extension is authorized.  MassHealth Essential members who are receiving MassHealth Essential on June 30, 2006 will be provided only MassHealth Limited coverage as of July 1, 2006, if otherwise eligible for MassHealth Limited under 130 CMR 505.008.

(E)  MassHealth Essential for Aliens with Special Status.  

(1)  Eligibility Requirements.  MassHealth Essential for aliens with special status is available to adults aged 19 through 64 who meet the eligibility requirements of 130 CMR 505.007, except that they must be aliens with special status, as described in 130 CMR 504.002(D), and in addition to being long-term unemployed, they must be disabled, as described in 130 CMR 505.002(F)(2)(a).

(2)  Availability of Benefits.  MassHealth Essential for aliens with special status is available either through the purchase of medical benefits or through premium assistance payments.  Benefits may begin no earlier than June 1, 2004, except as described in 130 CMR 505.007(E)(2).

(3)  Funding and Enrollment Restrictions.  MassHealth Essential members who are aliens with special status are subject to enrollment restrictions described in 130 CMR 501.003(C).  Upon advance notice, MassHealth Essential benefits may be terminated if the MassHealth agency determines that there is insufficient funding.

(4)  Eligibility for MassHealth Limited.  MassHealth Essential members who meet the requirements of 130 CMR 505.007(E) are automatically eligible for MassHealth Limited coverage.  Medical services are provided pursuant to 130 CMR 450.105(G).  MassHealth members meeting the requirements of 130 CMR 505.007(E) are eligible for MassHealth Limited benefits as follows.

(a)  For MassHealth Essential members with purchase of medical benefits, medical coverage begins in accordance with 130 CMR 505.008(B).

(b)  For MassHealth Essential members with premium assistance, medical coverage begins in accordance with 130 CMR 505.008(B) and is provided on a fee-for-service basis covering only MassHealth-covered services that are not covered by the member’s private health insurance.