On June 1, 2004, MassHealth will automatically upgrade eligibility for lawfully present elderly and disabled immigrants to MassHealth Essential. This is expected to restore benefits to some 2,700 of the estimated 10,000 legal immigrants who were cut from MassHealth Basic last August. MassHealth Essential provides more significant health care coverage than these immigrants are currently receiving on MassHealth Limited.

• Currently, this benefit is only funded through September 30, 2004.
• Those now getting MassHealth Limited do not need to reapply. Those not currently on MassHealth Limited, will need to apply.
• Advance notice to affected individuals went out on May 14, 2004.
• Re-enrollment on June 1, 2004 will be automatic for all those receiving the advance notice.
  • Disabled individuals with income over 100% of poverty will not be eligible for upgraded benefits.
  • Parents and caretaker relatives who may be disabled but have never had a disability determination from Social Security or MassHealth (DES) will not be automatically restored. They should call the MassHealth Enrollment Center and ask for a Disability Supplement in order to start the process of establishing disability. 1-888-665-9993.

People under age 65 with disabilities will have to choose a Primary Care Clinician before their MassHealth card starts covering more benefits. After June 1, 2004, they should call the Customer Service Center (1-800-841-2900) to choose a Primary Care Clinician.

• Elderly and disabled special status immigrants applying for MassHealth after June 1, 2004 will also be able to qualify for MassHealth Essential if family income is not over 100% of poverty.
• MassHealth will send out an advance notice prior to October 1, 2004 either continuing benefits or downgrading benefits to MassHealth Limited depending on what action the legislature takes by that date.
• The May notice includes a Question for Immigrants form. It is not necessary to return this form to get the automatic upgrade to MassHealth Essential. However, the form is another opportunity to establish that your client or patient has an immigration status that is eligible for MassHealth Standard.
  • U.S. entry before 8/22/96. Remember that non-citizens who entered the U.S. before August 22, 1996 (even if their entry was not lawful at that time) and continued to reside in the U.S. until getting legal permanent resident (or parole) status at a later date do NOT have to wait five years to be eligible for MassHealth Standard. To show that someone entered the US before the date on his or her permanent resident card, fill in the U.S. entry date box on the Question for Immigrants form.
  • Five years since obtaining legal permanent resident status. Return the Question for Immigrants form for anyone who got his or her permanent resident (or parole) status more than five years ago i.e. in 1999 or earlier.
  • Change in status. Return the Question for Immigrants form for anyone whose immigration status has changed for the better. For example, a person who had an application for asylum pending who has now been granted asylum will be federally eligible for Medicaid.
• MassHealth Essential covers more than MassHealth Limited. It covers the following emergency and non-emergency services:
  • Prescription drugs,
  • Inpatient and outpatient hospital services
  • Physician visits,
  • medical equipment and supplies, and
  • substance abuse and mental health services.
  • NOTE - MassHealth Essential does not cover any long-term care services such as nursing homes, home health aides, etc. It does not cover orthotics.

A fact sheet to give to patients about this change is available from the CRC or MIRA. This fact sheet will also be translated into Spanish, Russian, and Chinese.

MIRA is urging all who work with legal immigrants to call your State Representative and State Senator to urge them to provide funding to extend health care beyond September 30th! If you do not know your legislator, call 617-727-7030 or visit www.wheredoivotema.com.

FOR MORE INFORMATION: Contact your local Legal Services office or contact the Mass Immigrant and Refugee Advocacy Coalition (MIRA) 617/350-5480 or the Mass Law Reform Institute, 617/357-0700.

-Adapted from MIRA fact sheet "Initial MassHealth Restoration for Elderly and Disabled Legal Immigrants" and "MassHealth Restoration for Elderly and Disabled Legal Immigrants", Mass Law Reform Institute.

05/2004