MassHealth Managed Care Options in 2023

On April 1, 2023 MassHealth members subject to mandatory managed care will have a new set of managed care options. These changes do not apply to people 65 or over or Medicare beneficiaries with voluntary managed options in SCO or One Care, or to other MassHealth members with MassHealth secondary to another form of insurance. About 1.2 million people are enrolled in mandatory managed care. They received letters in February and March informing them of their initial assignment to a plan effective April 1, 2023. About 40% of these 1.2 million people were initally assigned to a new plan. People were initially assigned to a new plan if their primary care practice had moved to a new plan (in mandatory managed care, primary care providers can belong to only one plan; specialists and hospitals can belong to multiple plans) or if their old plan was no longer participating in MassHealth or serving their area. MassHealth members have a right to change the plan that will be effective April 1 2023 and  to change plans over the next 90 days. Also during that 90 day period, the new plan must provide continuity of care for services the individual was receiving from their old plan. The attached documents describe this transition in more detail and include a powerpoint presentation by MassHealth, and Tables put together by MLRI based on information from MassHealth and other organizations .

MassHealth Websites :

MassHealth Plans and Enrollment Guide: https://www.mass.gov/masshealth-plans-and-enrollment-guide

MassHealth Choices website  where members can learn about and compare health plan options and enroll online: https://www.masshealthchoices.com/en

MassHealth Health Plan Contracts: https://www.mass.gov/masshealth-health-plan-contracts

Available Primary Care Providers and ACOs starting April 1, 2023: https://www.mass.gov/info-details/available-primary-care-providers-and-masshealth-acos-starting-april-1-2023

MassHealth Choices page where members can enter their zip code for list of available plans, telephone numbers and plan websites (showing 2022 plans until April 1, 2023) https://www.masshealthchoices.com/en/Contacting-health-plans