The Massachusetts Medicaid plans list is made up of several health programs designed to give residents essential health services. These programs are especially helpful when you’re trying to find affordable coverage.
Medicaid health plans in Massachusetts combine Medicaid and the Children’s Health Insurance Program (CHIP) to meet the needs of people of all ages who qualify. In this guide, we’ll cover the various types of plans available, what they include, and how to enroll.
MassHealth is the Massachusetts Medicaid program. The program provides complete health coverage to individuals and families who qualify. This allows those who need it most to get the medical care they need without worrying about the cost.
The federal government brings significant funding to Massachusetts through MassHealth. This funding allows families and individuals with low incomes to get the healthcare they need. Because MassHealth provides access to quality healthcare, it helps people manage ongoing health issues and get preventive care so they can stay healthy.
In addition to those who benefit directly from the program, MassHealth contributes to the overall health and well-being of residents.
Massachusetts has different Medicaid plans to help people with different needs. When you apply for MassHealth and are approved, the program typically assigns you to a plan that fits your needs. However, you also have the option to choose a different plan if you prefer. These plans include:
MCOs work with a network of healthcare providers to offer various services. They manage care in two important ways: they ensure that patients get the necessary treatments and control the costs of services. To do this effectively, MCOs negotiate rates with care providers and use utilization management to ensure that each patient gets the necessary and affordable healthcare services.
WellSense Essential MCO and Tufts Health Together are examples of MCOs that offer Medicaid health plans in Massachusetts.
ACOs are groups of healthcare providers who work together to provide better care to MassHealth members. Their primary focus is improving health outcomes, reducing unnecessary costs, and coordinating care. Fallon Health, Tufts Health Together, and WellSense are a few MCOs that work with several ACOs to offer these services.
PCC plans offer primary care and other medical services for MassHealth members. This plan is usually for those who have not enrolled in an MCO or ACO. PCC plans let you choose a primary care clinician from the MassHealth list or have one assigned to you. You can also change your PCC at any time or switch your Medicaid plan from the PCC plan to an MCO or ACO whenever you choose.
MassHealth has various plans designed to fit different needs. Here’s a quick look at them so you can pick one that suits your needs:
MassHealth looks at your income, family size, and citizenship status to decide whether you qualify. Here’s a quick overview of the common eligibility criteria:
Here’s how to enroll in a program from the Massachusetts Medicaid plans list:
To learn more, read our guide on How to Get Medicaid in Massachusetts.
After you apply using a method you prefer, MassHealth will review your application to see if you qualify. If you are approved, the program will assign a plan that fits your situation. However, you can switch plans if you want a different one.
The various Massachusetts Medicaid plans help residents get affordable healthcare. In this guide, we covered the different plans and services available so you can make informed decisions about the type of healthcare you and your family may need.
MassHealth goes beyond healthcare. It creates a way for families and individuals (especially those with low income) to get better healthcare and financial stability. If you’re eligible, don’t hesitate to explore these options. And if you need assistance choosing a Medicaid plan, Abby Care is here to help. Get in touch with us today, and together, let’s figure out the next steps toward a healthier, happier you.
https://www.mass.gov/info-details/full-list-of-masshealth-acos-and-mcos
https://www.mass.gov/topics/masshealth-health-plans
