Medicaid Unwinding in Massachusetts: What You Need to Know If You Lose Coverage

The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. The PHE was renewed a dozen times between January 2020 and February 2023.

People who were eligible for Medicaid coverage during the PHE were able to keep their insurance — even if they became ineligible. This is because all 50 states — including Massachusetts — were mandated to provide continuous coverage during the PHE.

But the PHE ended on May 11, 2023, and most COVID provisions, like automatic Medicaid renewals, stopped nationwide in March. 

Promotional Disclosureinfo_outlined

SPECIAL OFFER

Prescription Savings Are Just the Beginning

See what other benefits you qualify for—from cashback cards to cheaper insurance.

Unlock Savings

In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are combined into a single program called MassHealth. The state has resumed eligibility reviews for MassHealth enrollees. This is called the redetermination process. Anyone who no longer qualifies could be disenrolled as early as June 2023. 

Here’s what you need to know about Medicaid changes in Massachusetts, and what to do if you lose your insurance coverage.

Why is Medicaid changing nationwide?

Now that the PHE has ended, COVID-19 will remain a public health priority — just not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid. 

The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories. It is already underway and could cause 5 million to 14 million enrollees nationwide to lose Medicaid coverage — including 300,000 people in Massachusetts.

What’s happening with Medicaid renewal in Massachusetts?

In Massachusetts, the Executive Office of Health and Human Services is responsible for overseeing MassHealth, the state’s Medicaid and CHIP programs. MassHealth has a redetermination plan that outlines how the state intends to conduct eligibility reviews for about 2.3 million enrollees through April 2024.

It’s important for you to confirm or update your household’s information with MassHealth so that you’ll get notified when it’s your turn for a renewal review. This information may include your mailing address, email, phone number, or income.

Read more like this

Explore these related articles, suggested for readers like you.

Medicaid Unwinding in Maine: What You Need to Know If You Lose Coverage

Medicaid Unwinding in Virginia: What You Need to Know If You Lose Coverage

Medicaid Unwinding in Wyoming: What You Need to Know If You Lose Coverage

Medicaid Unwinding in New Mexico: What You Need to Know If You Lose Coverage

View more

You can confirm or update your information by:

• Logging in to your account on the MassHealth MA portal

• Calling MassHealth customer service at 1-800-841-2900

• Visiting a MassHealth Enrollment Center (walk-in appointments are limited)

• Mailing a handwritten note with your MassHealth ID number, head of household name, head of household date of birth, and the change you want to report to Commonwealth of Massachusetts, Health Insurance Processing Center, P.O. Box 4405, Taunton, MA  02780

• Faxing a handwritten note with your MassHealth ID number, head of household name, head of household date of birth, and the change you want to report to 857-323-8300

What to expect during the renewal process

MassHealth may start to notify you about the eligibility redetermination process via text, email, or robocall. These alerts may come if they can’t reach you via the address on file. Community partners will also be knocking on doors as part of a renewal outreach plan.

About half of Medicaid enrollees will have their eligibility automatically confirmed through information available to the state, such as federal or state income. Those who can’t be automatically renewed will be sent a blue envelope with their renewal. You may receive a text or email if your renewal envelope is returned to MassHealth because you don’t have a current address on file.

Typically, you will have 45 days to respond to a renewal notice. (It’s 30 days for people in long-term care facilities.) If you respond and MassHealth still needs additional information, you’ll get another 90 days to respond.

MassHealth members younger than age 65 can submit renewals by:

• Signing into the Massachusetts Health Connector (MA Health Connector) online portal or the individual link provided in the renewal notice

• Mailing the completed paper application to the Health Insurance Processing Center, P.O. Box 4405, Taunton, MA 02780

• Faxing the completed application to 857-323-8300

• Calling MassHealth customer service at 1-800-841-2900

• Depositing the completed application in a drop box outside enrollment centers in Charlestown, Quincy, Tewksbury, Taunton, or Springfield

• Scheduling an appointment with a MassHealth representative that’s virtual, by phone, or in person

• Getting help from a certified application counselor or enrollment assister near you

MassHealth enrollees age 65 and older as well as those of any age living in a long-term care facility or on a home and community-based services waiver can:

• Mail the completed paper application to the MassHealth Enrollment Center, P.O. Box 290794, Charlestown, MA 02129.

• Fax the completed application to 617-887-8799.

• Deposit the completed application in a drop box outside enrollment centers in Charlestown, Quincy, Tewksbury, Taunton, or Springfield.

• Call MassHealth customer service at 1-800-841-2900.

• Complete your renewal online or upload it and submit electronically (if it has an e-submission number).

• Schedule an appointment with a MassHealth representative that’s virtual, by phone, or in person.

• Get help from a certified application counselor or enrollment assister near you.

Even if you think you may no longer qualify for MassHealth, you should submit your completed renewal form. This will help MassHealth determine if you qualify for other affordable healthcare options.

If you receive a termination notice, you will have at least 14 days before your coverage ends. If your case is closed because you didn’t respond to the renewal notice, you can contact MassHealth for a renewal consideration within 90 days of coverage ending to see if you can have your Medicaid reinstated back to the day your case was closed.

If you need to reach Massachusetts Medicaid by phone, call MassHealth at 1-800-841-2900.

Special populations

MassHealth will offer additional support for people with complex redeterminations or those who are especially vulnerable, including:

• Homeless: performing special outreach to members who are transient or without permanent addresses

• Disabilities: providing renewal accessibility and assistance

• Immigrants: reaching out to immigrants and refugees with translated information

• Children and families: connecting with parents of covered children and people who are aging out of certain coverage protections

• People who are age 65 and older: providing information about dual eligibility for Medicaid and Medicare as well as for people transitioning from Medicaid to Affordable Care Act plans on the Massachusetts Health Connector marketplace

What should I do if I lose my Medicaid coverage in Massachusetts?

In order to receive receive Medicaid in Massachusetts, you must meet all of the following criteria:

• You must be a Massachusetts resident with or without an address or have entered the state with a job commitment or seeking employment.

• You must be a U.S. citizen, permanent resident, or legal resident.

• You must need assistance with access to healthcare or insurance coverage.

• Your annual household income before taxes are withheld must be below the limit for your household size.

In Massachusetts, you may also qualify for reasons other than or in addition to income, including if you are:

• Pregnant

• A child or teenager

• Responsible for the care of a child who is 18 years old or younger

• Blind

• 65 years old or older (and meet certain criteria)

• A person with a disability, or you have a person in your household who has a qualifying disability

• A former foster child

• In need of nursing home care 

• HIV positive

• In need of treatment for breast or cervical cancer (and have been screened or are still undergoing treatment)

If you no longer qualify for MassHealth or the agency can’t reach you, you will no longer be able to use your benefits, which could leave you temporarily uninsured. 

If you lose your coverage but believe you still qualify, you can reapply for Medicaid. You may be uninsured for a while until you’re approved for coverage again.

If you choose not to reapply for Medicaid coverage, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications.

In addition, you may be able to enroll in an alternative health insurance plan such as:

• Affordable Care Act (ACA) marketplace plan: You may be able to enroll in an ACA health plan on Massachusetts Health Connector — also known as MA Health Connector or just Health Connector — which is the state’s ACA marketplace. You could find a plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan through Health Connector during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.

• Employer plan: If you have a job, you may be able to get employer-sponsored health insurance.

• Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.

• Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.

• Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.

• Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.

• U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.

Massachusetts Medicaid resources

Here are some resources where you can learn more about Medicaid in Massachusetts and upcoming changes related to the end of the public health emergency:

• Massachusetts Medicaid office: Learn more about the state’s Medicaid program, MassHealth, which is overseen and administered by the Massachusetts Executive Office of Health and Human Services.

• Massachusetts Medicaid self-service portal: Visit the MassHealth MA Login Account portal and access your account online 24/7 to confirm or update your contact information.

• Massachusetts Medicaid renewal: Read an extensive report on the unwinding in this MassHealth renewal help guide.

• Massachusetts Medicaid redetermination: Find out more about the state’s redetermination plan and explore its library of redetermination resources.

Why trust our experts?

Written by:

Veneta Lusk

Veneta Lusk is a personal finance and healthcare writer with 15 years of experience. She holds a bachelor of arts in journalism from the University of North Carolina at Chapel Hill.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Our editorial standards

Meet our experts