COMMONWEALTH CARE CLARIFICATIONS

An important clarification- the plans that have been receiving all the recent press about being too expensive are NOT the Commonwealth Care plans. These news stories pertain to Commonwealth Choice, private health plans that will be available from carriers like Blue Cross, via the state's "Connector" beginning in May for those who do not qualify for a subsidy (income is over 300% FPL). In contrast, Commonwealth Care plans are state subsidized plans that are already available from the four Medicaid managed care plans (NeighborhoodHealth Plan, Network Health, BMC Health Net, and Fallon).

Free Care As Wrap-Around

Commonwealth Care members continue to have Free Care for non-covered services (such as dental for those above 100% FPL; dental is included in Commonwealth Care for those under 100% FPL). If providers are unable to collect Commonwealth Care co-pays, they may submit a claim to the Free Care Pool for the unpaid co-payment.

Useful Tool – Health Coverage Eligibility

Pathways to Coverage provides eligibility flowcharts for Massachusetts public health insurance coverage. Their flowcharts have been recently updated to include Commonwealth Care. See: http://www.pathwaystocoverage.org/AccessDocument.cfm?document=PathwaysToCoverageDecember06final4%2Epdf, which is also linked from our website.

-Adapted from e-mail “Commonwealth Care - update, resources”, from KimSimonian, MPH Health Access and Community Partnerships, Community Benefit Programs, Partners HealthCare, January 29, 2007

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