MassHealth and Health Connector presenters explain coverage differences, premium assistance and how to get help

State presenters from MassHealth and the Health Connector described how the two programs serve different populations and how Massachusetts residents can determine which option fits them.

Belkis, a MassHealth presenter, said MassHealth is Massachusetts’ Medicaid and Children’s Health Insurance Program, providing free or low‑cost coverage based on income, age, disability and other criteria. "MassHealth members will have access to doctor's visits, dental coverage, prescription drug coverage, behavioral health services, and other important health care services if they are found eligible," she said. She stressed that MassHealth offers year‑round enrollment and that applicants may submit partial information and follow up later with missing documents.

The presentation summarized MassHealth coverage categories available to individuals and families: MassHealth Standard (comprehensive care); CommonHealth (for some disabled adults and children who do not qualify for Standard); CarePlus (typically adults without children who do not qualify for Standard); and Family Assistance (for certain children and adults with limited eligibility). Belkis also listed special programs: MassHealth Limited (typically covers emergency services only when immigration status restricts broader coverage), the Children's Medical Security Plan (primary and preventive care for uninsured children who do not qualify for other MassHealth benefits), and the Health Safety Net (assistance for certain hospital or community health center services for uninsured or underinsured residents). She noted that MassHealth Limited, the Children’s Medical Security Plan and the Health Safety Net are not considered insurance for tax purposes.

On premium assistance, Belkis described a program that can help MassHealth members who have access to employer‑sponsored insurance pay part of their premium and some out‑of‑pocket costs. "If you have MassHealth and have access to employer‑sponsored insurance you may be eligible to receive premium assistance," she said, adding that eligibility depends on whether the employer plan meets program requirements and on which MassHealth benefit the member or household qualifies for.

The presenters also highlighted the single‑application process: applicants use one form at mahealthconnector.org and the system determines whether they qualify for MassHealth or a Health Connector plan. A presenter noted applicants should report gross income on the application and can update the account later if income changes.

For help, MassHealth customer service is 800‑841‑2900; the Health Connector customer service line is 1‑877‑623‑6765. The presenters said there are seven MassHealth enrollment centers for in‑person assistance, certified application counselors and navigators at community health centers and hospitals, and SHINE counselors for people 65 and older (SHINE scheduling via 1‑800‑243‑4636 or shine@state.ma.us).

The session closed with a question‑and‑answer period in which panelists clarified that applicants should report gross income and that partial or draft applications can be saved and completed later. The presenters encouraged prospective applicants and small employers to use the online tools and local assisters to find personalized help.

The webinar did not include any formal votes or policy changes; it was an informational presentation and the agencies directed participants to existing customer service channels and local assisters for follow‑up.