How to keep your MassHealth coverage

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Massachusetts Law Reform Institute
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Once you are enrolled in MassHealth, you may have to take action to stay enrolled. At least once a year, MassHealth will check to see if you still qualify. This is called the "annual renewal" or "annual redetermination." MassHealth may also ask you to update certain information in between annual renewals. 

Learn more about MassHealth annual renewals and what to do about them in this article.

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What happens if I don’t give MassHealth my updated information?

If you are an adult and do not reply by the deadline they ask you to, you will probably lose your current coverage. Children under age 19 are protected from losing coverage in between their annual renewals.

See What if MassHealth ends my benefits?

How will I find out when MassHealth is doing my annual renewal?

Once MassHealth selects you for annual renewal: 

  • Some people get a letter from MassHealth saying they’re still eligible based on information MassHealth found on its own. 
  • Other people get a renewal form to fill out and return to MassHealth by a deadline. After returning the renewal form, some people will be asked to give additional information by a deadline.

People who aren’t eligible anymore will lose their current MassHealth coverage, and some people may lose coverage just for missing deadlines.

Important

Make sure MassHealth has your current mailing address. That way, you receive the renewal form or other letters from MassHealth about your coverage. See more about how to update your address.

What changes did MassHealth make to the renewal process?

Special protections were in place to keep MassHealth members from losing coverage based on redeterminations between March 18, 2020 and March 31, 2023 because of the COVID-19 pandemic. Between April 1, 2023 and March 31, 2024, MassHealth returned to checking the eligibility of all its members to see if they are still eligible. MassHealth made some changes to the way they do annual renewals to try to avoid people losing coverage who are still eligible.

MassHealth will check to see if you are still eligible. If they can’t renew your coverage automatically, they will send out a renewal form to see if you still qualify for MassHealth. The renewal forms will be mailed in a large blue envelope with the state seal on it.

MassHealth will also send out texts and make automated phone calls to let people know about the deadlines to return forms. MassHealth is also sharing information with your MassHealth managed care plan, and it may be calling you with reminders too.

How do I submit the renewal form?

You can complete a renewal form in all the same ways you can apply for MassHealth

Also, there is a way for some people 65 and older to fill out a fillable PDF renewal application online and submit it via secure email. Your renewal notice will include an “e-submission” number to let you use this option if it is available to you. 

You can get help from the same people that can help you apply. You can also go to in-person enrollment events held by MassHealth and community-based organizations. They can help you with renewals. 

Also check out these websites with information about the MassHealth redeterminations:

What if MassHealth ends my benefits?

If MassHealth terminates (ends) your current coverage because they say you do not qualify or didn't return information on time, you have the right to appeal. You should get a notice telling you the date your coverage is ending or changing for the worse and how to appeal. Find free legal help with your appeal.

If you get a notice ending or changing your coverage, you can temporarily continue to have your current coverage if you appeal:

  • before the date your benefits end or change, or 
  • within 10 days of receiving the notice. 

This is called “aid pending appeal."

If an enrollment assister helped you to apply or renew, ask them about your termination. They should be able to explain the reasons for a termination, your right to appeal, and refer you to legal assistance. Also, sometimes a termination is based on missing or wrong information that an enrollment assister can help you send in.

If your benefits are terminated for not returning the renewal notices that MassHealth began sending on April 1, 2023, you can be reinstated back to the date of termination for up to 90 days with no gap in coverage, but only if:

  • you return the late renewal form or other missing information and
  • are found eligible, and
  • call MassHealth to ask to have your benefits reinstated for the “90 day reconsideration period.”

This is a special rule that is in place until Dec 31, 2024.

Even if you return the late renewal form (or a late request for information) before the date of your termination, it will not automatically stop the termination. Only “aid pending appeal” will do that.

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Enrollment assisters
Health_MassHealth_Enrollment Assisters

Get help with applying for or renewing MassHealth or Health Connector coverage, or enrolling in a managed care plan.

The list of local Navigators and Certified Application Counselors includes the languages their staff speak. 

These organizations may also use phone interpreters to help you with other languages.

More information about MassHealth redeterminations
Health_MassHealth_Redeterminations

Visit these organizations' websites:

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