What insurance is similar to Masshealth?

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AG2Pupsters
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Joined: Mon Sep 13, 2021 10:11 pm

What insurance is similar to Masshealth?

Post by AG2Pupsters »

I hope I'm posting on the right section.

My father (age 58) is a self-employed carpenter (makes less than $10-$15k a year) and just lost his MassHealth coverage this month due to an increase in assets. I tried to find insurances similar to Masshealth and am not sure which one he should go with. He's afraid of not being able to afford the high cost of being in the emergency room for more than a week, not knowing English too well when doctors/nurses explain things, going under surgery and afraid of putting a burden on me. The reason for his fear is because we lost my mother few months ago for hydrocephalus and she was in the hospital for more than 3 weeks and her medical bills.

I tried looking into MAHealthConnector but the enrollment is closed. I'm trying to educate myself on insurance, but it seems confusing as to how much they will cover for emergency rooms for more than a week.

Does anyone have any insurance recommendations that my father should go with? Thank you so much.
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nisiprius
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Re: What insurance is similar to Masshealth?

Post by nisiprius »

I can't help you on the insurance question but you should help your dad become aware that in many medical settings, interpretation services are available. Around where I live, all the hospitals have placards showing the list of languages. Practically any practice that is associated with a big institution will be able to do this. Since it is mostly done over the phone it is widely available.

It is imperfect. I once coached a student I was tutoring about this. I actually stayed on the line with her. She was quickly connected to an interpreter, and things went fairly well, except for an obvious problem: while the interpreter was on the line they were told that they needed to speak to a different department and given another phone number... which didn't answer.

The point is, speakers of other languages should be coached. In every encounter with a medical professional they should say "I don't speak English. I speak Portuguese [or whatever]. I need an interpreter."

This is important when calling 9-1-1, too.

I am not 100.00% sure what happens at a pharmacy counter but the CVS chain claims to offer interpretation and I think all the big chains do. It is really important to use the "discuss my prescription with a pharmacist" option to be sure that the dosage directions and the major warnings are understood.

I am sure than in real life this means being a little assertive, slowing things down, waiting in a second line etc. etc. but the point is that speakers of other languages need to know that in medical settings language interpretation is probably available and they need to ask for it.
Last edited by nisiprius on Tue Sep 14, 2021 6:13 am, edited 1 time in total.
Annual income twenty pounds, annual expenditure nineteen nineteen and six, result happiness; Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.
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nisiprius
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Re: What insurance is similar to Masshealth?

Post by nisiprius »

Request an open enrollment waiver
Qualifying Life Event: If you have a qualifying life event—like getting married, losing a job, having a child, or losing health insurance coverage—you may be able to buy and enroll in health insurance outside of the open enrollment period. To learn more about qualifying life events, visit the Connector.

Request an open enrollment waiver | Mass.gov
That's just a web search result, I don't have any personal experience. I just thought to myself "that ain't right, you are supposed to be able to join ACA outside of the open enrollment period if there's a good need to."

How is your dad on using the Web? I see that this website offer a choice of languages. I don't know if these are high-quality translations or just Google Translate, but it may be helpful to him to read this kind of information in his own language.

Image

I also found:
Frequently Asked Questions about Open Enrollment Waivers
I am losing my current health insurance. Do I have to wait until open enrollment to enroll in a new health insurance?

Typically, losing health insurance is considered a qualifying life event. This includes losing health insurance through a job, becoming ineligible for MassHealth or ConnectorCare, or aging out of your parent’s plan when turning 26. You have 60 days from the date when you lose your health insurance to enroll in new health insurance.
Annual income twenty pounds, annual expenditure nineteen nineteen and six, result happiness; Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.
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JoeRetire
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Re: What insurance is similar to Masshealth?

Post by JoeRetire »

AG2Pupsters wrote: Mon Sep 13, 2021 10:28 pm My father (age 58) is a self-employed carpenter (makes less than $10-$15k a year) and just lost his MassHealth coverage this month due to an increase in assets.

I tried looking into MAHealthConnector but the enrollment is closed.
Go back to the website. You'll find that he is eligible due to losing his prior coverage.
Search for an acceptable plan there.
Just remember: it's not a lie if you believe it.
gtaylor
Posts: 350
Joined: Tue Feb 17, 2009 3:22 pm

Re: What insurance is similar to Masshealth?

Post by gtaylor »

> You have 60 days from the date when you lose your health insurance to enroll in new health insurance.

Note that unlike cobra they don't do retroactive enrollment, it tends to be "pay by the 18th for coverage starting the first of the next month". So if you want it effective for Oct 1, you'd better hustle. (Other states use the 15th, MA gives you a few more days than that each month).

In practice I would expect that he will qualify for one category or other of heavily subsidized plans through the Connector. Honestly, at 15k I am surprised he got pushed out at Mass Health.

I have enrolled via the connector. Their forms are tedious, particularly if you are filling out all the income stuff for subsidies. Furthermore, the MassHealth (Medicaid) and Connector Care (subsidized commercial) and APTC related items on the website forms are all sliced and diced from these various agencies' paper forms into one all in one form in such a way that it can be rather confusing.

My suggestion is that you and your dad sit down with a speakerphone for an hour or two and do the whole thing on the phone with a connector phone rep, not using the website yourself. At least get your application entirely done that way, so the agent can help you get the form filled out correctly the first time. Once the application is in the system and approved, you can see on the website the available plans with true subsidized costs, and it is then straightforward to pick one and enroll.

In terms of what insurance he should pick, any of the connector plans will more or less eliminate the chance of catastrophic emergency room bills. Be sure the network is suitable for dad's location, and not limited in general (there is no out of network coverage). Keep an eye out for Silver options with extra low copays and deductibles due to cost sharing subsidies, there is a narrow income band above MassHealth and below "mere" PTC territory where these plans provide excellent bang for the buck, in many cases paying for more than Gold plans at less than the Silver rate.
Topic Author
AG2Pupsters
Posts: 5
Joined: Mon Sep 13, 2021 10:11 pm

Re: What insurance is similar to Masshealth?

Post by AG2Pupsters »

nisiprius wrote: Tue Sep 14, 2021 5:54 am I can't help you on the insurance question but you should help your dad become aware that in many medical settings, interpretation services are available. Around where I live, all the hospitals have placards showing the list of languages. Practically any practice that is associated with a big institution will be able to do this. Since it is mostly done over the phone it is widely available.

It is imperfect. I once coached a student I was tutoring about this. I actually stayed on the line with her. She was quickly connected to an interpreter, and things went fairly well, except for an obvious problem: while the interpreter was on the line they were told that they needed to speak to a different department and given another phone number... which didn't answer.

The point is, speakers of other languages should be coached. In every encounter with a medical professional they should say "I don't speak English. I speak Portuguese [or whatever]. I need an interpreter."

This is important when calling 9-1-1, too.

I am not 100.00% sure what happens at a pharmacy counter but the CVS chain claims to offer interpretation and I think all the big chains do. It is really important to use the "discuss my prescription with a pharmacist" option to be sure that the dosage directions and the major warnings are understood.

I am sure than in real life this means being a little assertive, slowing things down, waiting in a second line etc. etc. but the point is that speakers of other languages need to know that in medical settings language interpretation is probably available and they need to ask for it.
Thank you so much! We didn't know this option is available.
Topic Author
AG2Pupsters
Posts: 5
Joined: Mon Sep 13, 2021 10:11 pm

Re: What insurance is similar to Masshealth?

Post by AG2Pupsters »

nisiprius wrote: Tue Sep 14, 2021 6:01 am Request an open enrollment waiver
Qualifying Life Event: If you have a qualifying life event—like getting married, losing a job, having a child, or losing health insurance coverage—you may be able to buy and enroll in health insurance outside of the open enrollment period. To learn more about qualifying life events, visit the Connector.

Request an open enrollment waiver | Mass.gov
That's just a web search result, I don't have any personal experience. I just thought to myself "that ain't right, you are supposed to be able to join ACA outside of the open enrollment period if there's a good need to."

How is your dad on using the Web? I see that this website offer a choice of languages. I don't know if these are high-quality translations or just Google Translate, but it may be helpful to him to read this kind of information in his own language.

Image

I also found:
Frequently Asked Questions about Open Enrollment Waivers
I am losing my current health insurance. Do I have to wait until open enrollment to enroll in a new health insurance?

Typically, losing health insurance is considered a qualifying life event. This includes losing health insurance through a job, becoming ineligible for MassHealth or ConnectorCare, or aging out of your parent’s plan when turning 26. You have 60 days from the date when you lose your health insurance to enroll in new health insurance.
My dad is a caveman when it comes to computers or the internet. He still uses a flip phone.

He told me he's going to lose MassHealth because my mother who past away decided to give him the house I've grown up in and her rental property which means an increase income and asset. I've been looking through different insurances in Massachusetts to see if they have similar coverage to MassHealth.
Topic Author
AG2Pupsters
Posts: 5
Joined: Mon Sep 13, 2021 10:11 pm

Re: What insurance is similar to Masshealth?

Post by AG2Pupsters »

JoeRetire wrote: Tue Sep 14, 2021 6:12 am
AG2Pupsters wrote: Mon Sep 13, 2021 10:28 pm My father (age 58) is a self-employed carpenter (makes less than $10-$15k a year) and just lost his MassHealth coverage this month due to an increase in assets.

I tried looking into MAHealthConnector but the enrollment is closed.
Go back to the website. You'll find that he is eligible due to losing his prior coverage.
Search for an acceptable plan there.
Even he has inherited assets (house I've grown with my mom and her rental property) and increase in income?
Topic Author
AG2Pupsters
Posts: 5
Joined: Mon Sep 13, 2021 10:11 pm

Re: What insurance is similar to Masshealth?

Post by AG2Pupsters »

gtaylor wrote: Tue Sep 14, 2021 7:54 am > You have 60 days from the date when you lose your health insurance to enroll in new health insurance.

Note that unlike cobra they don't do retroactive enrollment, it tends to be "pay by the 18th for coverage starting the first of the next month". So if you want it effective for Oct 1, you'd better hustle. (Other states use the 15th, MA gives you a few more days than that each month).

In practice I would expect that he will qualify for one category or other of heavily subsidized plans through the Connector. Honestly, at 15k I am surprised he got pushed out at Mass Health.

I have enrolled via the connector. Their forms are tedious, particularly if you are filling out all the income stuff for subsidies. Furthermore, the MassHealth (Medicaid) and Connector Care (subsidized commercial) and APTC related items on the website forms are all sliced and diced from these various agencies' paper forms into one all in one form in such a way that it can be rather confusing.

My suggestion is that you and your dad sit down with a speakerphone for an hour or two and do the whole thing on the phone with a connector phone rep, not using the website yourself. At least get your application entirely done that way, so the agent can help you get the form filled out correctly the first time. Once the application is in the system and approved, you can see on the website the available plans with true subsidized costs, and it is then straightforward to pick one and enroll.

In terms of what insurance he should pick, any of the connector plans will more or less eliminate the chance of catastrophic emergency room bills. Be sure the network is suitable for dad's location, and not limited in general (there is no out of network coverage). Keep an eye out for Silver options with extra low copays and deductibles due to cost sharing subsidies, there is a narrow income band above MassHealth and below "mere" PTC territory where these plans provide excellent bang for the buck, in many cases paying for more than Gold plans at less than the Silver rate.
He told me he can't have Masshealth anymore because he inherited the house (childhood home I'm grown up with my mom in) and rental property which will increase his income and assets.

Thank you so much for educating me about insurance. I truly appreciate it.
2bits
Posts: 8
Joined: Wed Dec 24, 2014 3:58 pm

Re: What insurance is similar to Masshealth?

Post by 2bits »

Based on income, he should be eligible for a ConnectorCare Type 1 or 2A plan with $0 premium, $0 deductible, and $0 or modest copays. See https://www.mahealthconnector.org/wp-co ... w-2021.pdf for a summary.

Depending on where in MA he lives, there may be a couple of choices of insurers for the free ConnectorCare plans; they all have the same costs, as shown in the summary, and differ only in their network. Here is a map: https://imgur.com/a/bq9NFMI

For projected income, simply use the prior year's income as reported to the IRS; that should avoid any need for further documentation.
Morgan22
Posts: 69
Joined: Thu Oct 29, 2015 12:30 pm

Re: What insurance is similar to Masshealth?

Post by Morgan22 »

You can own a home and still be on MassHealth. What matters is income and countable assets. You can call 800-841-2900 to ask them about eligibility or do some research on the internet and find the limits.
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JoeRetire
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Re: What insurance is similar to Masshealth?

Post by JoeRetire »

AG2Pupsters wrote: Wed Sep 15, 2021 9:33 pm
JoeRetire wrote: Tue Sep 14, 2021 6:12 am
AG2Pupsters wrote: Mon Sep 13, 2021 10:28 pm My father (age 58) is a self-employed carpenter (makes less than $10-$15k a year) and just lost his MassHealth coverage this month due to an increase in assets.

I tried looking into MAHealthConnector but the enrollment is closed.
Go back to the website. You'll find that he is eligible due to losing his prior coverage.
Search for an acceptable plan there.
Even he has inherited assets (house I've grown with my mom and her rental property) and increase in income?
Neither inherited assets, nor increase in income affect his eligibility for an ACA health plan.
Just remember: it's not a lie if you believe it.
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