Back to Insights and Updates for ProvidersDecember 2023

Reminder: Redetermination for Medicaid patients

Tufts Health Public Plans

As the Medicaid redetermination process continues, we once again remind our provider partners of the important role they play in ensuring that some of our most vulnerable members and their families do not lose coverage. Medicaid renewals impact several Point32Health plans, including Tufts Health Together (MassHealth ACO/MCO), Tufts Health RITogether (Rhode Island Medicaid), Tufts Health Unify (Medicare-Medicaid), and Tufts Health Plan Senior Care Options (65+ Medicare-Medicaid plan).

Please remind your Medicaid patients that they must take action to renew coverage for themselves and their families, including responding to requests for information from the state and returning renewal forms by the date specified. In addition, to avoid any coverage issues, your staff may want to call patients before their appointments to ensure their coverage will still be active at the time of their appointment.

In Rhode Island, state redetermination of eligibility for Rite Care members (families with children, pregnant women, and children under 19) begins for the first time as of Jan. 1, 2024. We encourage pediatricians and OB providers to discuss renewal with parents/caregivers of Medicaid patients. During this conversation, remind patients to check addresses and contact information they have on file with the state and make updates as necessary. If you need assistance regarding member’s eligibility, contact the Gainwell provider support line at 401-784-8100.

To increase patient awareness, we’ve created flyers, posters, and digital signage for provider use. To request these materials — cobranded with your practice’s logo —email marketing_memberservices@point32health.org.

If a patient has missed a renewal deadline, they can contact the state to submit their application. Individuals who take action within 90 days of their term date can be retro-enrolled back to their term date without a gap in coverage, if they still qualify.

Resources for Massachusetts members

The Mass.gov website includes details on renewing MassHealth coverage, including instructions and contact information. Helpful sections include the MassHealth Enrollment Assister and MassHealth Enrollment Centers (MECs).

Members who are deemed ineligible for MassHealth may still qualify for subsidized Connector Care plans and should call the Massachusetts Health Connector at 877-MA-ENROLL (877-623-6765, TTY: 877-623-7773), or visit the website.

Resources for Rhode Island members

At StayCoveredRI.gov, members can check and update their contact information, learn more about the Medicaid renewal process, and sign up to receive text messages about their coverage. Resources include sample Medicaid notices, contact information, and certified application counselors and navigators to assist patients.

Members who are deemed ineligible may still qualify for subsidized coverage and should call HealthSource RI at 855-840-4774 or visit the website.


Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

Joseph O’Riordan, Susan Panos, Ryan Francis, Stephen Wong,
Writers

Kristin Edmonston,
Production Coordinator

Kristina Cicelova,
Graphic Designer