Massachusetts Immigrant and Refugee Advocacy Coalition
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Update on New Health Care Plan for 31,000 Immigrants

QA-on-New-CeltiCare-Health-Plan.pdf QA-on-New-CeltiCare-Health-Plan.pdf
9/ 2/2009 4:46 pm - The Patrick administration announced its plans on Monday for the $40 million allocated to coverage for 31,000 immigrants under the "Aliens with Special Status" (AWSS) category in MassHealth who lost eligibility for Commonwealth Care as of September 1, 2009. According to the Patrick Administration, CeltiCare, a new managed care organization (MCO), will provide coverage to all 31,000 immigrants impacted by the cuts, through a health plan with a benefit package similar to Commonwealth Care. The major differences we know of between Commonwealth Care and the new plan are: * No vision, dental, hospice or skilled nursing services * Increased co-pays for some services ($25 for specialty care/$50 for non-generic prescriptions/$250 inpatient services) * No choice of MCO (All 31,000 will be enrolled in CeltiCare) To read more and access attachments, click above link.

CeltiCare, as a new MCO, still needs time to develop its provider network statewide, so the plan will be rolled out over the course of two months to different areas of the state (click here to view CeltiCare's current network by region). The tentative schedule for enrollment in the new plan calls for members in the current CeltiCare provider and geographic network to become enrolled in the new plan as of October 1, 2009, with a rolling enrollment process in other portions of the state. As of December 1, 2009, the administration expects all 31,000 immigrants impacted by the cuts to be enrolled in the plan. Enrollment will be automatic, so no additional application is necessary.

In the meantime, folks in this population of 31,000 will be eligible for the Health Safety Net and some will also be eligible for MassHealth Limited during the gap in coverage. Those impacted by the cuts should have already received letters informing them of their eligibility for these programs.

In some bad news, there is a cap on future enrollment in the new plan. This means that those enrolled in Commonwealth Care as of August 31, 2009 in the AWSS category will be eligible for enrollment in the new plan, whereas those who fall under this category in the future will only have access to the Health Safety Net and MassHealth Limited.

As many details are still unknown, MIRA will send out updates on additional details and information about the plan as they become available. Attached is a Q&A provided by the Administration in response to questions from MIRA and other stakeholders.

Below are some additional resources and information for health care consumers, outreach workers, and others impacted by the cuts to Commonwealth Care:

    * MIRA and its allies have already found that many immigrants have been miscategorized as "Aliens with Special Status" and may still be eligible for improved health care benefits. Click here to view a fact sheet by MA Law Reform Institute on how to ensure that MassHealth has the correct immigration information for consumers.

    * MIRA has put together a more accessible definition of "Aliens with Special Status" using MassHealth regulations.

    * Patients should check with their current providers to see if they accept Health Safety Net. If they don't, patients should contact their local community health center. Folks can contact the Health Safety Net Help Desk at 1-877-910-2100 to find out where their nearest community health center is.


    * If you continue to have questions about the changes or about determining immigration status, please contact Toby Guevin at MIRA at 617-350-5480 x216 or tguevin@miracoalition.org. Trainings are also available for interested organizations.

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