PHE Redeterminations - Frequently Asked Questions
Public Health Emergency Redeterminations - FAQ's
Q. What is the Public Health Emergency (PHE) for COVID-19?
A. A federal PHE is a declaration by the U.S. Department of Health and Human Services (HHS) that allows states to take special actions. These include expanding health care coverage or adding benefits.
In March 2020, the federal government declared a public health emergency (PHE) due to the COVID-19 pandemic. In response to the PHE and consistent with federal continuous coverage requirements, MassHealth put protections in place that prevented MassHealth coverage from ending during the COVID-19 emergency.
Q. What is the status of the PHE for COVID-19?
A. The protections that the PHE for COVID-19 offered are ending in April 2023. This means that hundreds of thousands of Massachusetts residents may lose MassHealth coverage and will need new health insurance options. Many of these individuals may be employees who will need coverage through their employer’s plan or from a different source.
Q: How and when will this change be implemented?
A. MassHealth will return to its standard annual eligibility renewal process. Starting April 1, 2023, all current MassHealth members will need to renew their coverage to ensure they still qualify for benefits. The renewals will be phased in over a 12-month period through April 2024. Members could receive renewal notices in the mail between now and April 2024.
Q. What does this mean to me as an employer in Massachusetts?
A. Massachusetts requires everyone to have health insurance or face a tax penalty. If one of your employees is losing MassHealth coverage, it is important that you help them find new coverage on a timely basis.
Q. I want to help my employees, but I’m not sure what the options are.
A. Begin by sharing this information regarding the MassHealth redetermination process with your employees. In the event an employee receives notification they no longer qualify for MassHealth, there are several options below.
- If you offer health coverage, an eligible employee can be enrolled in your plan.
- If you do not offer health coverage, you can create a company plan and invite employees to sign up. HSA Insurance has several licensed account executives on staff who would be happy to assist you in finding the best plan to meet your needs.
- If you do not offer employer coverage or have employees that are not eligible, your employees can enroll in individual coverage through HSAInsurance.com.
- If you do not offer coverage or have employees that are not eligible, but who may qualify for help paying for coverage,
- We can assist them with getting an estimate to determine if they may qualify for financial assistance or
- If they would prefer to check on their own, they can visit the MA Health Connector site at https://betterhealthconnector.com/get-an-estimate
Q. How do I add an employee to my plan through HSA Insurance?
A. You can follow your usual process with HSA Insurance for adding an employee or dependent to your company’s plan by simply emailing email@example.com.
Q. What should I do if my employee wants to enroll in individual coverage through HSA Insurance?
A. Our experienced account executives are available Monday through Friday from 8:30am-5:00pm to assist your employee in finding the best plan to meet their needs.
Ask them to call us at (781) 228- 2122.
Q. What do I need to do to determine if my MassHealth coverage will be renewed?
A. MassHealth will be processing renewals from April 2023 - April 2024. If you receive a blue envelope with a renewal notice, or any other mail with a call to action from MassHealth, you must respond.
Q. Why am I receiving a blue envelope?
A. If your renewal cannot be automatically processed by MassHealth, you will receive a blue envelope in the mail to complete and return to MassHealth. Typically, you will have 45 days to respond to the renewal notice.
Q. I received notification from MassHealth that I am no longer eligible for coverage. What should I do next?
A. Because you lost your coverage through MassHealth you now have a Qualifying Life Event. You have 60 days from your loss of coverage date to enroll in coverage. To avoid a gap in coverage, we recommend that you evaluate your options as soon as possible.
Q. What are my coverage options?
A. Depending on your employment status and your income, you have a few options.
- Speak to your employer about being added to your employer’s plan. If your employer offers health insurance coverage, you may be eligible to enroll.
- If you are unemployed, your employer does not offer coverage or if you are not eligible to enroll in your employer’s plan, you can enroll in individual coverage through HSAInsurance.com. You have 60 days from your loss of coverage date to enroll.
- Depending on your income, you may qualify for help paying for coverage.
- We can assist you in determining if you are likely to receive financial assistance. Use the Get an Estimate calculator on the MA Health Connector website at https://betterhealthconnector.com/get-an-estimate
- If you would prefer to check on your own, you can visit the MA Health Connector site at https://betterhealthconnector.com/get-an-estimate
- If you determine that you do not qualify for financial assistance, you can enroll through HSA Insurance. We offer many plan choices, and our service is unparalleled.