22. What happens when MassHealth members become eligible for ConnectorCare?

Sometimes when people are no longer eligible for MassHealth, they may become eligible for ConnectorCare. This might be based on an increase in income, decrease in family size, or a change in age, health status or immigration status. In this situation, MassHealth will time the termination of benefits for the last day of the month, or the end of the following month to allow time for ConnectorCare enrollment. To avoid a gap in coverage, the individual must select a plan and pay any premium due by the 23rd  of the month to be enrolled in ConnectorCare by the first of the following month. 130 CMR 502.006(D).
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Advocacy Reminder:

If parents living with children under 19 have an increase in earned income that puts them over 133% FPL, there is a special work incentive program called Transitional Medical Assistance (TMA) that will continue the family’s MassHealth Standard coverage for 12 months. 130 CMR 505.002(L)(3). At the end of the 12 months, MassHealth will send a form seeking updated income information and if family income is not over 300% FPL and the parents do not have other Minimum Essential Coverage, they should transition to ConnectorCare and the children to Family Assistance. The children will be exempt from a Family Assistance premium if their parents are paying a premium for ConnectorCare. 130 CMR 506.012(J)(4)