Special Enrollment Period (SEP) for Former MassHealth Members

As you and your team members continue to help consumers with their applications and enrollment into Health Connector coverage, please review and share the following reminders:

Helping those no longer eligible for MassHealth coverage

If someone recently lost or loses their MassHealth coverage as part of the MassHealth renewal process, that is considered a Qualifying Life Event (QLE). 

This means they can enroll in a plan with the Health Connector outside of the regular Open Enrollment Period.

The Health Connector continues to extend a special enrollment period until November 23, 2024, for those individuals who lost MassHealth during calendar year 2024, or on or after April 1, 2023, and have since been determined eligible for but remain unenrolled in a qualified health plan. For more information, review the Health Connector’s Administrative Information Bulletin 01-24 Guidance Regarding Special Enrollment Periods Due to the End of the Medicaid Maintenance of Effort (MOE) and the Federal COVID-19 Public Health Emergency (PHE) and National Emergency for Calendar Year 2024.

To review the complete policy on qualifying events for individuals and families go to: Policy NG-5 Mid-Year Life Events or Qualifying Events (mahealthconnector.org). To find all Health Connector policies, go to the Policy Center Policies – Massachusetts Health Connector (mahealthconnector.org).

Note: Closed enrollment rules do not apply to enrollment in MassHealth, Health Safety Net (HSN), Children's Medical Security Program (CMSP), or a Health Connector dental plan or those enrolling in Health Connector for Business.