MassHealth Residency Policy and Procedure Clarification

 

In January 2011, MassHealth revised paper and “Virtual Gateway” applications to identify those who are "visitors" to the Commonwealth of Massachusetts and to determine their eligibility using current policy (i.e., this is not a change in policy but change in procedure to implement that policy).To clarify policy and procedures, there are plans underway to change the applications to focus on whether an individual is a resident of the Commonwealth, rather than a visitor.  The MassHealth Residency Policy/Procedure Clarification (note: no longer available online) provides guidelines and further clarification for determining eligibility, for the processing of applications, and a description of future enhancements that are targeted for Fall 2011. 

Clarification Document Excerpts

Immigration status and residency are separate eligibility factors. Individuals of any immigration status must have the opportunity to prove residency. MassHealth plans to change the MBR and SMBR to focus on whether individuals are residents of the Commonwealth, rather than visitors. Until these revisions are implemented, MassHealth has issued clarifications about the provided visitor information.  

Clarification Of Residency Policy/Procedures

MassHealth will use the following guidelines when determining eligibility for benefits.

• Consider any children born in Massachusetts who have lived in MA from the time of their birth as meeting the residency rules for MassHealth eligibility.
• Recognize that immigration status and residency are separate eligibility factors. People of any immigration status must have the opportunity to prove residency.
• If applicants/members provide a copy of a “Visitor” or “Student” visa, but indicate on the application that they are not a visitor they may be considered residents of the Commonwealth if they currently live in MA and intend to stay.
• Will not request the following information for Nonqualified Aliens:
• verification of immigration status; or
• a visa for verification of immigration or MA residency.
• Reminder: Nonqualified aliens may be eligible for MassHealth Limited, Healthy Start, Children’s Medical Security Plan, or Health Safety Net.
• Recognize that undocumented immigrants may be considered residents of Massachusetts.
• Provide appeal rights to any applicants or members who are denied benefits as “not a resident.”

-Adapted from “MassHealth Residency Policy and Procedure Clarification”, MA Health Care Training Forum, July 13, 2011 and the guidance document (no longer available online). See MassHealth Member Eligibility Regulations > see 503.002

 

 

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