Other State and Federal Insurances and Coverages
COMMONWEALTH CARE
The Commonwealth Care Health Insurance Program was created in 2006 as a result of Massachusetts health reform law. This insurance is required for residents who do not have health insurance, who are aged 19 or older, and whose income is at or below 300% of the federal poverty level (FPL). They must not be eligible for MassHealth. There are 3 choices: Plan Type 1, Plan Type 2 and Plan Type 3. Once you have submitted an application and it has been reviewed, you will be notified as to which of the three plan types you are eligible for. You will then choose from one of the Managed Care Organizations that offer plans in your area.
COMMONWEALTH CHOICE
The Commonwealth Choice program is for those who have an income higher than 300% of the federal poverty level and who are unable to get insurance from their jobs. This insurance option is also for small businesses with fewer than 50 employees. Some individuals who have the option of a health insurance through their employer but who would rather buy a Commonwealth Choice plan may be eligible to enroll in Commonwealth Choice. For more detailed information on plans, benefits, premium and co-payments go to the Health Connector at: www.mahealthconnector.org
MASSHEALTH (MEDICAID)
MassHealth, known in other states as Medicaid, is a public health insurance program for low to medium income residents of Massachusetts. MassHealth offers several types of coverage and eligibility for individuals or families is based on income, family situation, health status, and other factors. Each program has its own type of coverage, cost and application. For more detailed information on programs visit: http://www.mass.gov/eohhs/gov/departments/masshealth.
HEALTH SAFETY NET
Health Safety Net (HSN), which used to be called Free Care, is a state benefit available to some low income uninsured or underinsured residents of Massachusetts. Health Safety Net can help pay for some health or pharmacy services for qualified individuals. You do not need to be a U.S. Citizen to be eligible for the Health Safety Net but you do need to live in Massachusetts. If you have Medicare and qualify for this coverage, the Health Safety Net can pay for some health services that Medicare does not cover and for medications, as long as you get the care at a hospital or community health center. The Health Safety Net pays for your services after Medicare or any other insurance you may have has already been billed. Where can I fill my prescriptions with the Health Safety Net? HSN has a limited number of CHC or hospital outpatient pharmacies in its network and each requires that your prescription be written by a clinician who works at that affiliated facility. In most cases, you will need to see a doctor at the hospital or community health center where the pharmacy is located in order to have your prescription filled there. The Health Safety Net will not pay for prescriptions you get filled at a local retail pharmacy (for example, CVS, Walgreens, etc.) unless they have a special agreement with a neighboring Community Health Center.
You can apply for Health Safety Net by filling out a MassHealth application called the Medical Benefit Request (MBR).
For an application go to: http://www.mass.gov/eohhs/consumer/insurance/masshealth-apply.
This information is provided by the Division of Health Care Finance and Policy
For more information on any of these benefits and programs and to request applications, contact the MCPHS Pharmacy Outreach Program at 866-633-1617.