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How do I figure out who my insurer is?

Produced by Mental Health Legal Advisors Committee
Reviewed June 24, 2009

If you think you have Medicaid, call MassHealth

Call the MassHealth Customer Service Center at 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss). Give them your Social Security number and they will tell you what program you are enrolled in. There are many different MassHealth programs, depending on how you became eligible for Medicaid.

Some people receive assistance from MassHealth, but do not get a card

These individuals include:

  • Family Assistance Premium Assistance program enrollees - MassHealth pays the insurance premium, but the family does not receive MassHealth services
  • "Buy-ins" - MassHealth pays the Medicare premium but does not provide any other services

Fee-for-service coverage

MassHealth sometimes pays the premiums for other groups of people who have private insurance or Medicare. If MassHealth does this, you have what is called fee-for-service coverage. You will have a MassHealth card if MassHealth covers services not paid for by the private insurance or Medicare.

Most people who receive Commonhealth will have a MassHealth card, but also are not part of MassHealth's managed care program (PCC or HMO). They are considered to be part of the fee-for-service program.

Most families receiving transitional assistance or low-income persons with disabilities are covered by either a health maintenance organization (HMO) or by the primary care clinician (PCC) program. You probably will have a MassHealth card. If you are enrolled in an HMO, you will have a card from the HMO, too.

Medicare and MassHealth

If you have been getting SSDI for two years, you probably have Medicare. Remember, if your SSDI payments are low, you may also be getting MassHealth.

Commonwealth Care and Commonwealth Choice

You may have one of the Connector plans, Commonwealth Care or Commonwealth Choice, insurance propgrams created as a result of the 2006 Massachusetts Health Reform Law requiring all adults to have health insurance if it is affordable. For more information on Commonwealth Care and Commonwealth Choice plans, visit the Connector website or call 1-877-723-7773.

Divorce and Private Insurance

If you are divorced or separated and your ex is working, you may have private insurance through your ex’s employer. If you’re on speaking terms with your ex, ask who the insurer is.

Finally, if you are still unsure, ask the billing office of your doctor or therapist.

NOTE: Private and public insurers sometimes contract with separate companies that manage their mental health benefits. These managed care companies decide whether your insurance will pay for your mental health care.

Next: Who decides what mental health services I get?

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