Known as MassHealth, Massachusetts offers a Medicaid program to low-income individuals and families who need assistance with healthcare. The federal government partners with the state to ensure enough funding gets provided to those who truly need the insurance. Residents across Massachusetts facing financial difficulties can apply for state health insurance and see if they qualify. Certain stipulations exist for those hoping to get approved.
Massachusetts’s Requirements for Medicaid Qualification
Enrollees must meet the requirements set forth by the state. Using the MassHealth website, applicants can discover if they would qualify or if they should skip the process. A summary of eligibility requirements is listed on the site, including being a resident of Massachusetts, having citizenship of the United States, and meeting income requirements. Children under age 19 and women who are pregnant may qualify more easily.
How to Apply for Medicaid in Massachusetts
The main method currently available for applying for Medicaid in Massachusetts is through the online interface. You may also call the service center at (800) 841-2900 24 hours a day to use the self-service option. If you want to speak with someone, you will have to call between the hours of 8 am and 5 pm Monday through Friday. Several enrollment centers also exist in Massachusetts if you wish to apply in person. They open at 8:45 am and remain open until 5 pm.
If you prefer to download and fill out a copy of the form, that option is available as well. It can then be mailed to the Health Insurance Processing Center. Be aware that this option takes the longest, as the mailed application needs to be received, get looked over by a worker, and given approval or denial before you can receive notification of your status.
Massachusetts Medicaid Application
The Medicaid application is fairly standard, asking for personal details such as full name, address, and telephone number. You must also disclose who all the members of your household are and which assets each of them has. The amount of financial and other assets in anyone’s name gets added and divided to determine if you all meet the income eligibility requirements. Bank account information must also get disclosed.
What Does Medicaid Cover in Massachusetts?
The Massachusetts Medicaid program covers various services. Children and adults alike can receive annual well-check exams. Emergency room or urgent care visits are also allowed, as well as emergency dental services, such as cracking a tooth or experiencing terrible pain. People can look into their specific plan details to see a full list of services covered by their insurance.
Income Requirements for Massachusetts Medicaid
Families applying for Medicaid in Massachusetts must meet certain income requirements. They have to fall below 100% of the Federal Poverty Rate, which equates to roughly $973 per month for a single adult. The more members of the family, the higher the income limit becomes to accommodate more people.
How Much Does Medicaid Cost in Massachusetts?
The state of Massachusetts and the federal government work together to pay for the cost of Medicaid. More than $17 billion gets spent on the health care of eligible residents each year, with projections expected to grow in the future. The state spends more than 23 percent of their total budget on Medicaid funding.
Cost and Coverage of Medicaid in Massachusetts
Most Medicaid recipients do not have to pay much towards their care. Many are extremely low-income and therefore cannot cover the extravagant costs associated with healthcare expenses. There is, however, a copay amount designated for various services. For a prescription drug, for example, members may have to spend up to $3.65 to pick up their prescriptions. There is also a $3 charge for acute inpatient stays.
Prescription Drugs with Medicaid in Massachusetts?
The Medicaid plans of Massachusetts cover prescription drugs, however, pharmacists are obligated to fill prescriptions with a generic version first if applicable. A doctor must request prior authorization from the insurance company if a brand-name version must get utilized in its place. There is more likely to be a copay involved with a brand-name drug than with a generic kind.
Which Medicaid plan is best in Massachusetts?
Tufts Health Public Plans, Inc. was rated as one of the best Medicaid choices in the state of Massachusetts. With a score of 4.5, this HMO plan has a strong pull with the people of the state. The National Committee for Quality Assurance rates all insurance plans across the board, giving them each a score of 0 out of 5.