Qualifying for Health Safety Net
The Health Safety Net (HSN) is available to uninsured and underinsured Massachusetts residents whose family income is under a certain percentage of the Federal Poverty Level (FPL):
- Massachusetts residents with income between 0-150% of the FPL may be eligible for the Health Safety Net.
- Massachusetts residents with income above 150% and equal to, or less than 300% FPL may be eligible for the Health Safety Net with a deductible.
The HSN can act as a secondary payer for eligible individuals enrolled in:
- private insurance,
- student health insurance,
- certain MassHealth programs,
- Qualified Health Plan, or
- ConnectorCare (for the first 90 days)
Applications and qualifications are available on line here: Member Booklet for Health and Dental Coverage and Help Paying Costs (ACA-1). Required steps include:
- Complete application for financial assistance.
- Have a Modified Adjusted Gross Income (MAGI) of less than, or equal to 300% Federal Poverty Level.
- Be a Massachusetts resident.
- Provide proof of identity.
There is no member card for Health Safety Net. You may want to keep any letters you receive about your eligibility for programs to show the hospital or community health center. These letters generally contain an “ID” or identification number which is helpful for providers.
You will need to renew your HSN coverage annually. Pay attention to any letters requesting more information.
You may receive a renewal request or letters requesting more information, before the year is over. If you do, make sure to complete them as soon as possible.
If any of the following things change, call the MassHealth office (800) 841-2900 immediately to give them your new information:
- phone number
- health insurance
- income changes
Failure to report changes may result in your losing any current coverage or HSN.
Health Safety Net Providers: Where you can get health services paid by HSN
You can use the HSN only at acute care hospitals and community health centers.
The HSN will pay for hospital facility charges. Examples of this include room and bed, nurses, technicians and equipment. At many hospitals, the doctors bill separately and their charges would not be covered by HSN. You may have to pay bills for the doctors and for some services like lab tests and x-rays if these services are provided by a private company and not the hospital itself.
A list of HSN providers can be found under the Information For Patients section.
Health Safety Net pharmacies
The HSN has a limited number of community health center or hospital outpatient pharmacies in its network. Each requires that your prescription be written by a clinician who works at that affiliated facility. A list of HSN registered pharmacies is provided below.
Some drugs may require that the doctor from the hospital or community health center request Prior Authorization before the pharmacy is able to complete the prescription. The HSN only pays for prescriptions you get filled at a local retail pharmacy (for example, CVS, Walgreens, etc.) if they have a special agreement with a neighboring community health center.
Health Safety Net and insurance
If you qualify for Health Safety Net and have no insurance.
If you qualify for HSN, and have an income between 0 to 150% of the Federal Poverty Level (FPL), you will not have a deductible.
If you do not have any other insurance, and have an income between 150.1% to 300% FPL, you may have an HSN deductible amount to the hospital or health center where you receive health services.
If you qualify for Health Safety Net and have private insurance.
The HSN may pay for services your insurance does not cover, if you get the care at a hospital or community health center. If you have HSN Secondary, your other insurance will need to be billed first for health services before the HSN is billed. You may also be responsible to pay an HSN deductible amount to the hospital or health center.
If you have private insurance with a high deductible or coinsurance and are eligible for HSN, providers may be able to bill the HSN.
Your provider will first bill your insurance for services.
Then your provider will bill you for any deductible required for the HSN.
After that, the provider may be able to bill the HSN for the deductible required by your private insurance. The HSN will pay for deductibles and coinsurance. It does not pay for co-payments required by private insurance plans.
If you qualify for Health Safety Net and have Medicare.
The HSN may pay for services that Medicare does not cover, if you get the care at a hospital or community health center. The HSN pays for your services after billing Medicare, Medicare Advantage and/or any other supplemental insurance you may have.
If you qualify for Medicare, the HSN may be able to assist with deductibles, co-insurance and copayments.
If you qualify for Health Safety Net and have ConnectorCare.
If you have been determined eligible for ConnectorCare, you have 90 days of HSN medical eligibility starting on your date of application to enroll in a ConnectorCare plan. If you do not enroll within this time period, you will no longer be eligible for HSN medical services. You may still be eligible for certain dental services at a community health center that provides dental services.
If you fail to pay your ConnectorCare premiums, you will not be eligible for medical services from the HSN. You may still be eligible for certain dental services from a community health center. You may be able to work out a payment plan with the Health Connector, even after termination. Please contact the Health Connector at 1-877-MA-ENROLL for more information.
If you qualify for Health Safety Net and have MassHealth.
The HSN generally pays for the same set of services covered by MassHealth Standard. They will do so only if the services are provided by a Massachusetts acute hospital or community health center.
HSN pays for certain adult dental services no longer covered by MassHealth.
You may also be responsible to pay an HSN deductible amount to the hospital or health center.
Patient billing and deductibles
If you have HSN and are billed by a provider
Be sure to check with the provider to see if the HSN will cover all the services you receive, or just some. If you receive a bill from a provider, contact them to inquire if they are a provider that is able to bill HSN, or if they are a private doctor, lab etc.
If you have a deductible listed for your Health Safety Net
The hospital or community health center will collect the amount that you owe.
You can pay your deductible to the hospital or community health center where you get services. It is very important to keep track of your payments. This will help you to have a record of when you reach your deductible.
HSN does not track your deductible. It is up to you and the hospital or community health center where you receive services to co-ordinate the collection of deductible payments.
Health Safety Net co-payments
Patients aged 21 and older who use the HSN pay co-payments for prescription drugs filled under HSN.
The co-payment amounts are:
- $1 for generic drugs in the following drug classes: antihyperglycemics (diabetes drugs), antihypertensive (high blood pressure drugs), and antihyperlipidemics (high cholesterol drugs).
- The co-payment is $3.65 for other generic drugs and $3.65 for brand-name drugs.
- There is an annual maximum of $250 per patient on pharmacy co-payments.
- Currently there are no other copayments for HSN.
- Please refer to above section: Patient billing and deductibles, if you have a deductible.
How to file a grievance with HSN
This page provides information about how to file a grievance with the HSN.