Continuity of Care (COC)

Supporting Member Transitions to New MassHealth Plan Options

On April 1, 2023, new MassHealth health plans will be available to members. Starting that day, if you’re a MassHealth member and you’re moving from your old plan to a new plan, you will have a “continuity of care” period of 90 days.

The goal of the continuity of care period is to help reduce disruptions in care. During this period, you may keep seeing any providers in your old plan who you have been working with before. These providers do not have to be part of your new health plan.  Any existing prior authorizations will also be honored by your new health plan. This includes any current drug prescriptions.  

You should get in touch with your new health plan if you have any questions or problems with continuity of care. You can also contact MassHealth Customer Service for help.

The list of health plans available to MassHealth members as of April 1, 2023, and information about each, can be found in the MassHealth Enrollment Guide.

Member-specific information to ease the transition

Keep the following points in mind:

• If you’re changing plans on April 1, 2023, you can continue to see your existing providers for 90 days, even if those providers are not in your new plan’s network.
• You should contact your new plan now to let them know of any ongoing treatments or scheduled appointments.
• MassHealth and the health plans will be working together to securely transition all prior authorization and referral information for transitioning members to support continuity of care.
• Plans are required to not deny any claims that require a prior authorization until they are able to transition all member information into their own systems.

What Members Can Do If They Have Concerns About Their Care During the Transition

There are a number of steps you may take to ensure a smooth transition if you have concerns or specific health needs:

• Contact your new plan. You should let your new plan know about any planned visits with your providers. You should also tell them about any authorized hospitalizations and drugs you are currently taking. Your new plan can let you know if your current providers will be covered beyond the 90-day continuity of care period, help you find new providers if necessary, and coordinate any prior authorizations needed. The contact information for all plans that will be available to members on April 1, 2023, is in the “Customer Service Centers” section below.
• Call MassHealth Customer Services at [phone], TDD/TTY:711. If you want help selecting or enrolling in a plan that contracts with a particular provider, MassHealth can provide that information, and help you select and change plans. You should also call MassHealth if you have an urgent situation that is not being addressed by your new plan. Some providers have trained staff called Certified Application Counselors who can help you.
   

Customer Service Centers

MassHealth, as well as all ACOs and MCOs, have customer service lines to answer questions. Please see below for customer service center contact information.

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Accountable Care Partnership Plans	Customer Service Phone	Behavioral Health Phone
BeHealthy Partnership Plan	[phone]	[phone]
Berkshire Fallon Health Collaborative	[phone]	[phone]
East Boston Neighborhood Health WellSense Alliance	[phone]	[phone]
Fallon 365 Care	[phone]	[phone]
Fallon Health Atrius Health Care Collaborative	[phone]	[phone]
Mass General Brigham Health Plan with Mass General Brigham ACO	[phone]	[phone]
Tufts Health Together with Cambridge Health Alliance (CHA)	[phone]	[phone]
Tufts Health Together with UMass Memorial Health	[phone]	[phone]
WellSense Care Alliance	[phone]	[phone]
WellSense Beth Israel Lahey Health (BILH) Performance Network ACO	[phone]	[phone]
WellSense Boston Children's ACO	[phone]	[phone]
WellSense Community Alliance	[phone]	[phone]
WellSense Mercy Alliance	[phone]	[phone]
WellSense Signature Alliance	[phone]	[phone]
WellSense Southcoast Alliance	[phone]	[phone]

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Primary Care ACOs	Customer Service Phone	Behavioral Health Phone
Community Care Cooperative (C3)	[phone]	[phone]
Steward Health Choice	[phone]	[phone]

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MCOs	Customer Service Phone	Behavioral Health Phone
WellSense Essential MCO	[phone]	[phone]
Tufts Health Together	[phone]	[phone]

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PCC Plan	Customer Service Phone	Behavioral Health Phone
Primary Care Clinician (PCC) Plan	[phone]	[phone]

Questions?

We are here to help.

• MassHealth Customer Service Center: [phone], TDD/TTY: 711
• For information about the MassHealth program, visit www.mass.gov/masshealth

Learn, Compare, and Enroll online

Find a doctor, compare plans, and enroll online at www.MassHealthChoices.com

Information for Providers

Providers looking for continuity of care information can find it in All Provider Bulletin 363,