Back to Insights and Updates for ProvidersSeptember 2023

Supporting Medicaid patients with redetermination

Tufts Health Public Plans

We want to ensure that our Medicaid members are aware that they must take action to renew their coverage — and you and your practice play an important role in assisting with these efforts. Medicaid renewals impact several Point32Health plans, including Tufts Health Together (MassHealth ACO/MCO), Tufts Health RITogether (Rhode Island Medicaid), Tufts Health Unify (Medicare-Medicaid), Tufts Health Plan Senior Care Options (65+ Medicare-Medicaid plan).

Please remind your Medicaid patients to complete the renewal process and to respond to any requests for information they receive from the state. 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.

Point32Health has developed materials for provider offices to use to help remind patients to renew their Medicaid coverage including: a handy member flyer in English and Spanish, digital signage, and posters. All materials can be cobranded with your practice’s logo. To request those materials, email [email protected].

If a patient has missed a renewal deadline, they can contact the state and 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.

If a member has questions, here are a few resources you can direct them to:

Massachusetts

  • Call MassHealth at 800-841-2900 (TTY:711), Monday–Friday, 8 a.m. to 5 p.m. or the MA Health Connector at 1-877-MA-ENROLL (1-877-623-6765, TTY: 1-877-623-7773), Monday-Friday, 8 a.m. to 6 p.m.
  • Look online for an enrollment assister in their area.
  • Visit one of the MassHealth Enrollment Centers (MECs). Appointments can be made online.

The Mass.Gov website includes details on renewing MassHealth coverage, including renewal instructions and contact information. Members who are deemed ineligible may still qualify for subsidized Connector Care plans and should visit the Massachusetts Health Connector website or call 1-877-MA-ENROLL (1-877-623-6765, TTY: 1-877-623-7773) to learn more . The Health Connector can help individuals apply and enroll.

Rhode Island

Rhode Island providers who need assistance with a member’s eligibility can call the Gainwell provider support line at 401-784-8100. Members who are deemed ineligible may still qualify for subsidized coverage and should visit the HealthSource RI website or call 1-855-840-4774, Monday-Friday, from 8 a.m. to 6 p.m. to learn more. HealthSource RI can help individuals apply and enroll.


Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

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

Kristin Edmonston,
Production Coordinator

Kristina Cicelova,
Graphic Designer