MassHealth Reinstatement Notices Prior to March 31, 2023

Over the last six months, advocates have brought cases to light of people losing MassHealth despite the continuous coverage protection  based on reported changes that were treated by the computer system as voluntary withdrawals when that was not what the member intended. A voluntary withdrawal was one of the few exceptions to the Medicaid continuous coverage protection. After investigating these and other cases, MassHealth has identified 20,000 people who are entitled to have their benefits reinstated.

In late March MassHealth sent out two different reinstatement letters. One went to people who had been terminated and had not yet reestablished eligibility for MassHealth benefits, the other went to people who had reestablished eligibility,  but only after a gap period in which they had no coverage. A remedy for a third group of people who had been terminated and were now enrolled in ConnectorCare is still under review.

The notice supplies a telephone number to the MassHealth unit designated to field questions (not the general Customer Service Center 800 #) such as how to be reimbursed for covered services paid or how to have unpaid bills incurred for covered services during the retro period paid. People who do not want to be reinstated can also call to opt out. Template notices are attached.

Like all MassHealth members enrolled after March 18, 2020 through March 31, 2023 these individuals will remain eligible until they are selected for renewal at some point after April 1, 2023 and receive a new determination based on that renewal.

How these system issues will be addressed after April 1, 2023 remains to be determined.

Attached are copies of these two kinds of notices and a set of FAQs prepared by MassHealth for people receiving these notices. 

If you have clients who received any of these reinstatement letters, please let us know how the process is working out for them. We’re interested in hearing both about any problems or confusion as well as the value to your clients of regaining coverage or clearing up medical debt. vpulos@mlri.org and ksymmonds@mlri.org