MassHealth: What You Need to Know About Redetermination


MassHealth is resuming its annual eligibility reviews, commonly known as “redeterminations,” which will take place over the course of 12 months.

What does this mean?

As the state returns to the standard redetermination process in the coming months, you can anticipate being evaluated for MassHealth coverage at least once a year.

The timing of this redetermination will be determined by the date you initially became a Mass Health participant.

It is imperative that if you receive a renewal packet, you respond by the specified due date. Failure to do so could result in the loss of your Mass Health coverage.

To make sure you are adequately prepared for this process, there are a few steps you can take:

  • Update your information: keep your address, phone number, and email address current with the MassHealth office. This will help facilitate communication and ensure that you receive important notifications.
  • Report changes: If there are any changes in your household, such as a new job, alterations in income, or changes in disability status, report them immediately to your local MassHealth office.

Here are additional details about the redetermination process:

Massachusetts:

  • The redetermination process began April 1, 2023, with automatic renewal for MassHealth members who remain eligible. Individuals at risk of losing eligibility will also be contacted.
  • Redeterminations are expected to continue through 2024.
  • MassHealth will send you a blue envelope requesting information if your renewal cannot be processed automatically.
  • Respond within 90 days to the request for information and submit to a subsequent 90-day renewal review.
  • Stay informed about the redetermination process by signing up to receive updates from MassHealth.
  • If you have questions or receive a blue envelope, contact Member Services at 866-610-2273 (TDD/TTY 711) for assistance.
  • For additional assistance, Massachusetts residents can contact Health Care for All at 800-272-4232 (TDD/TTY 711) or the MassHealth Customer Care Center at 800-841-2900 (TDD/TTY 711).
MassHealth Redetermination

Important Reminder:

MassHealth is designed to provide health care coverage to low- and moderate-income persons residing in Massachusetts.

This program offers direct health care benefits or help with health insurance premium payments.

MassHealth offers several coverage options based on factors such as your age, pregnancy, disability, HIV status, breast/cervical cancer diagnosis, and employment with a small employer.

Who is eligible for MassHealth?

Eligibility criteria for MassHealth include:

  • Residency in the Commonwealth of Massachusetts.
  • U.S. citizen, permanent resident or legal alien status
  • Demonstrated need for medical care/insurance assistance
  • Financial situation characterized as low income or very low income
  • For people with disabilities, there is no income limit. May qualify by paying a premium and a single deductible.

How to Apply for MassHealth

Applying for MassHealth is easy and convenient.

You can apply online through the Massachusetts website, by visiting the Health Connector’s virtual table on My Health Fair.

We encourage you to explore these options and take advantage of the program to ensure your health care needs are met.

If you have any questions or need assistance during the application process, please do not hesitate to contact MassHealth Customer Service.

Your health and well-being are our priority, and we are here to help you every step of the way.

As you navigate the redetermination process, remember that keeping your information up-to-date and responding quickly to requests is key to maintaining your MassHealth coverage.

By staying engaged and informed, you can ensure that your health insurance remains secure, allowing you to access the care you need.

Our sources: https://www.mass.gov/

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