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Consumer Assistance Available after Open Enrollment

Consumer Assistance Available after Open Enrollment

January 23, 2020

The Massachusetts Health Connector Open Enrollment period officially closes on January 23, 2020. However, this does not mean enrollment is “closed” for everyone. The Open Enrollment period is the annual time for Health Connector members to change their plan for any reason, and for new applicants to shop for health insurance without a “qualifying life event.”

So what happens on Health Care For All’s HelpLine and with all the enrollment assisters across the state on January 24th? The answer is (drum roll, please): a lot. Consumer assistance programs that help people enroll into health insurance are not limited to aiding people with their applications during the Open Enrollment period. They do so much more. Enrollment assisters continue to be busy post-Open Enrollment because many people can apply for health insurance after that day, or because they may experience life changes that require updating their coverage. People who qualify for MassHealth, the Health Safety Net, Children’s Medical Security Plan and people who would be newly determined eligible for ConnectorCare, can apply at any time throughout the year. Other people may be eligible for what is known as a Special Enrollment Period. This allows them to go through the Health Connector to shop for private insurance if they experience qualifying life events such as moving, employment or income changes, marriage, divorce, birth, change in household dependents, and loss of health insurance. Also, if an individual is member of a federally recognized tribe or Alaska Native shareholder, they are able to apply for health insurance at any time.

On December 9, 2019, The Boston Globe published a piece that I wrote about what it is like to work on the HelpLine and the importance of consumer assistance. This piece paints a picture of the broad range of issues handled on the HelpLine throughout the year.

The HelpLine troubleshoots health insurance issues that can happen at any point in the year in English, Spanish and Portuguese. HelpLine counselors regularly make conference calls with clients and MassHealth or the Health Connector to diagnose problems and resolve coverage issues. Those calls do not stop once enrollment is completed. Callers want to know how to use their coverage, how to understand the out of pockets costs associated with their plan, and if they can get any other assistance with their health care expenses. In addition, people already on coverage need help updating their applications through the Health Connector and MassHealth throughout the year when they experience a change.

Successful consumer assistance is provided by community organizations understanding how to reach the communities they work with, and providing culturally competent aid in the languages most spoken in the area(s) they serve. Consumer assistance for health insurance is needed year round and this important work should get the financial support that it requires and deserves. Health Care For All is advocating for additional funding for programs like the HCFA HelpLine to continue the crucial work being done day in and day out. Consumer assistance is pivotal in keeping Massachusetts as the #1 in coverage rates, and making sure consumers have access to affordable health care when they need it. 

- Hannah Frigand, Director, Education and Enrollment Services at Health Care For All