Masshealth Customer Service

masshealth customer service logo

MassHealth is a state-run health insurance program in Massachusetts that provides coverage to eligible residents. The program offers a wide range of benefits, including doctor visits, hospital stays, prescription drugs, and more. MassHealth customer service is available to help members with any questions or concerns they may have about their coverage.

To contact MassHealth customer service, members can call the toll-free number at 800-841-2900. The call center is open Monday through Friday from 8 a.m. to 5 p.m. TDD/TTY services are available for those who are deaf or hard of hearing. Members can also visit one of the MassHealth enrollment centers or health plan offices located throughout the state.

MassHealth offers a variety of resources to help members manage their coverage and stay informed about changes to the program. MyServices is an online portal that allows members to respond to mail they have received from MassHealth, report changes to their household, and submit requested information. MassHealth also sends text and email reminders to members about renewing their coverage and other important updates.

About MassHealth

MassHealth is a public health insurance program in Massachusetts that provides health coverage to eligible low- and moderate-income individuals and families, including children, seniors, and people with disabilities. It is administered by the Massachusetts Executive Office of Health and Human Services (EOHHS) and is funded by both state and federal governments.

To be eligible for MassHealth, individuals must meet certain income and asset requirements, as well as residency and citizenship status. MassHealth offers a variety of health plans, including the Primary Care Clinician (PCC) Plan, which assigns members to a primary care provider who coordinates their care, and the Health Safety Net (HSN), which provides free or low-cost care to uninsured or underinsured individuals who meet certain income requirements.

MassHealth members have access to a range of benefits, including doctor visits, hospital stays, prescription drugs, dental and vision care, and more. Some benefits may require prior authorization or have limitations on coverage. MassHealth also offers resources and programs to help members manage their health, such as care coordination, disease management, and wellness initiatives.

MassHealth is committed to providing high quality care to its members and has established regulations and initiatives to ensure that health plan contracts meet certain standards. MassHealth members can also access a variety of resources and information through the Mass.gov website, including eligibility information, enrollment options, and health plan details.

For assistance with MassHealth, individuals can contact the MassHealth Customer Service Center at (800) 841-2900. The customer service representatives are available Monday through Friday from 8 a.m. till 5 p.m. and can provide help with eligibility, benefits, enrollment, and more.

MassHealth Customer Service

MassHealth provides health benefits and help paying for them to qualifying children, families, seniors, and people with disabilities living in Massachusetts. If you have any questions or concerns regarding MassHealth, you can contact their customer service center at (800) 841-2900. The customer service representatives are available Monday through Friday from 8 a.m. till 5 p.m.

MassHealth also offers a secure website where you can access your account, view your benefits, and manage your coverage. The website is protected by an https certificate, ensuring that your information is secure. If you have any feedback about the website, you can provide it through the website feedback form.

If you prefer to contact MassHealth through email, you can send a message to their customer service email address. However, it is important to note that email is not a secure method of communication, and sensitive information should not be shared through email.

In addition to phone and email, MassHealth also offers a hotline for reporting fraud. If you suspect someone is committing fraud against MassHealth, you can call the fraud hotline at 1-877-437-2830 (1-877-4-FRAUD-0).

Overall, MassHealth is committed to providing excellent customer service to its members. Whether you have questions about your benefits, need help managing your coverage, or want to report fraud, MassHealth is here to help.

How to Contact MassHealth

MassHealth provides various ways to contact their customer service center for assistance. The easiest and most convenient way is to call their customer service number at (800) 841-2900. Customer service representatives are available Monday through Friday from 8 a.m. till 5 p.m. They can help with eligibility, MassHealth benefits, and other inquiries related to MassHealth.

If you prefer to contact MassHealth via mail, you can use the following addresses:

  • Provider Services: MassHealth Provider Services, P.O. Box 278, Quincy, MA 02171
  • Forms Distribution: MassHealth Forms Distribution, P.O. Box 278, Quincy, MA 02171
  • Claims: MassHealth Customer Service, P.O. Box 7, Quincy, MA 02171

MassHealth also provides an official website, .mass.gov, where you can find information and resources related to MassHealth. You can apply for MassHealth, enroll in a MassHealth health plan, and manage your MassHealth account online through the website.

If you need to report any changes to your address, email, or phone number, you can do so online, by phone, in person, by mail, or by fax. You must report any changes to MassHealth as soon as possible, but no later than 10 days from the date of the change.

MassHealth also has enrollment centers and health insurance processing centers located throughout Massachusetts. You can find a list of these centers on the MassHealth website.

In addition to these options, MassHealth also provides appointment scheduling services for certain types of appointments. You can schedule an appointment online through their website or by calling their customer service number.

MassHealth also provides various resources for providers, including provider bulletins and information on how to enroll as a MassHealth provider. If you are a MassHealth provider, you can contact MassHealth’s provider services department at (800) 841-2900 for assistance.

Overall, MassHealth provides multiple ways to contact their customer service center and obtain assistance with your MassHealth account.

MassHealth for Special Groups

MassHealth provides special services for individuals with disabilities, individuals who need long-term care services, individuals over 65 years of age, and individuals who need a doctor. If you fall into any of these groups, MassHealth has resources available to help you.

People with Disabilities

MassHealth provides a range of services for individuals with disabilities. These services include:

  • Personal Care Attendant (PCA) services
  • Home health services
  • Medical equipment and supplies
  • Behavioral health services
  • Transportation to medical appointments

If you have a disability and need assistance, MassHealth offers a dedicated customer service line. You can call (800) 841-2900 to speak with a representative who can help you navigate the services available to you.

Long-Term Care Services

MassHealth offers long-term care services for individuals who need assistance with daily activities, such as bathing, dressing, and eating. These services include:

  • Nursing home care
  • Home health services
  • Adult day health services
  • Assisted living services

If you need long-term care services, MassHealth can help you find the right provider and navigate the application process. You can call (800) 841-2900 to speak with a representative who can help you get started.

Doctors

MassHealth provides coverage for doctor visits, including primary care, specialist, and behavioral health services. If you need to find a doctor, MassHealth has a searchable directory of providers available on their website.

Over 65

MassHealth provides coverage for individuals over 65 years of age who meet certain income and asset requirements. This coverage includes:

  • Doctor visits
  • Prescription drugs
  • Hospital stays
  • Long-term care services

If you are over 65 and need assistance, MassHealth offers a dedicated customer service line. You can call (800) 841-2900 to speak with a representative who can help you navigate the services available to you.

Billing and Providers Information

MassHealth provides important information for providers about billing and submitting claims. Providers can check their claim status, submit and void claims, and submit a 90-day claim waiver request form or an electronic claims waiver request. All dental claims must be submitted electronically, unless the provider has a claims paper waiver on file.

MassHealth’s Provider Services can be reached by phone at (800) 841-2900, Monday through Friday from 8:00 a.m. to 5:00 p.m. Providers can also contact MassHealth through mailing addresses for Provider Services, Forms Distribution, and Claims.

In addition, MassHealth offers a Provider Library with publications and resources for providers, as well as information on prior authorization and eligibility verification. Providers can also enroll and credential with MassHealth through MassHealth Provider Enrollment and Credentialing.

MassHealth also offers transportation services for members, and providers can find information on transportation through MassHealth Transportation Information for Providers.

Overall, MassHealth provides a variety of resources and services for providers, including billing and claims information, publications, provider enrollment and credentialing, prior authorization, and transportation services. Providers can reach MassHealth’s customer service number for assistance with any questions or concerns.

Feedback and Fraud Reporting

MassHealth values feedback from its members and providers to improve its services. Members and providers can share their feedback, complaints, or suggestions by contacting MassHealth Customer Service at (800) 841-2900.

MassHealth takes fraud seriously and has several options to report fraud. Members and providers can report any suspected fraud, waste, or abuse to MassHealth Fraud Hotline at 1-877-437-2830 (1-877-4-FRAUD-0). The Attorney General’s Medicaid Fraud Division also investigates and prosecutes health care providers who defraud the Massachusetts Medicaid program, known as MassHealth. Members and providers can file a complaint online or contact the Medicaid Fraud Division at (617) 727-2200.

MassHealth also encourages its members and providers to test new features and report any changes. Members and providers can contact MassHealth Customer Service to learn about new features and report any issues or changes they experience while using MassHealth services.

In summary, MassHealth provides several options for feedback and fraud reporting. Members and providers can contact MassHealth Customer Service for feedback and report fraud to the MassHealth Fraud Hotline or the Medicaid Fraud Division. MassHealth also encourages its members and providers to test new features and report any changes.

Pharmacy and Prescription Drugs

MassHealth provides coverage for prescription drugs to eligible members. The program covers a wide range of medications, including brand-name and generic drugs. MassHealth also has a Pharmacy Program that offers additional services to members.

If you have questions about pharmacy billing, pharmacy policy and prior authorizations, the Drug Utilization Program, or the MassHealth Drug List, you can contact the MassHealth Pharmacy Services. You can find their contact information on the Mass.gov website or call the MassHealth Customer Service Center.

To get prescription drugs covered by MassHealth, you need to have a prescription from a licensed healthcare provider. Some medications may require prior authorization (PA) from MassHealth before they are covered. The MassHealth Drug List (MHDL) provides a list of drugs that are covered by the program.

MassHealth also has a Preferred Drug List (PDL) that includes medications that are preferred by the program due to their safety, effectiveness, and cost. If a medication is not on the PDL, it may still be covered by MassHealth, but it may require PA.

If you need help finding a pharmacy that accepts MassHealth, you can use the Pharmacy Search Tool on the Mass.gov website. The tool allows you to search for pharmacies by location, pharmacy name, or pharmacy type. You can also use the tool to find pharmacies that offer additional services, such as home delivery or medication synchronization.

Overall, MassHealth’s Pharmacy Program provides comprehensive coverage for prescription drugs to eligible members. If you have any questions or concerns about your pharmacy benefits, you can contact the MassHealth Pharmacy Services for assistance.

Exploring MassHealth Plans and Benefits

MassHealth provides its members with a range of health care services, resources, and benefits. It is important to understand the different MassHealth plans and benefits available to make informed decisions about health coverage.

MassHealth offers several health plans, including the Primary Care Clinician (PCC) Plan, which is the default plan for most members. Members can also choose from other health plans, such as the Managed Care Organization (MCO) Plan or the Accountable Care Organization (ACO) Plan. Each plan has its own network of providers, so it is important to check if your preferred doctor or hospital is covered by the plan you choose.

In addition to health plans, MassHealth also offers dental coverage for eligible members. This coverage includes preventive services, such as cleanings and exams, as well as restorative services, such as fillings and extractions.

To be eligible for MassHealth, individuals must meet certain income and residency requirements. The MassHealth Eligibility Verification System (EVS) can be used to check eligibility status. Members can also use the MassHealth Choices website to compare and enroll in a health plan.

MassHealth benefits include coverage for a variety of health care services, such as doctor visits, hospital stays, prescription drugs, and mental health services. Members may also be eligible for additional benefits, such as transportation to medical appointments and assistance with health insurance premiums.

Overall, MassHealth provides its members with access to comprehensive health care services and benefits. For more information on MassHealth plans and benefits, members can contact MassHealth Customer Service Center at (800) 841-2900.

Frequently Asked Questions

How do I contact MassHealth customer service?

MassHealth customer service can be contacted by phone at (800) 841-2900. Representatives are available Monday through Friday from 8 a.m. till 5 p.m. For people who are deaf, hard of hearing, or speech disabled, TDD/TTY 711 is available.

How do I log in to my MassHealth account?

To log in to your MassHealth account, visit the MassHealth website and click on the “Sign In” button located in the top right corner of the homepage. Enter your username and password to access your account.

What is the MassHealth website?

The MassHealth website is https://www.mass.gov/masshealth. It is the official website for MassHealth, a program that provides healthcare coverage to eligible Massachusetts residents.

How do I find my MassHealth ID number?

Your MassHealth ID number can be found on your MassHealth card. If you do not have your card, you can contact MassHealth customer service at (800) 841-2900 to obtain your ID number.

What is the income limit for MassHealth eligibility?

The income limit for MassHealth eligibility varies depending on the program. Some programs have no income limit, while others have income limits that are based on a percentage of the federal poverty level. To find out if you are eligible for MassHealth, you can use the eligibility checker on the MassHealth website or contact MassHealth customer service at (800) 841-2900.

Scroll to Top