What happens if MassHealth decides that you're ELIGIBLE, but you're NOT ELIGIBLE?

What happens if MassHealth decides that you're ELIGIBLE, but you're NOT ELIGIBLE?

For example, if you call MassHealth and they sign you up for Temporary MassHealth coverage, then you see your doctor, and then after that, MassHealh says, "Whoops, we overlooked something and you were NOT eligible in the first place. Our mistake, sorry!" Do you have to pay the full cost of the doctor's bill or will MassHealth still pay it?

Let's say you provided 100% correct information and the person at MassHealth simply goofed.

Has this happened to anyone on here?

(MassHealth just signed me up for temporary coverage, but according to every online document I can find, I don't qualify. I'm considering calling MassHealth back to confirm my eligibility.)

Absolutely call them back to fid out what happened and if there is something they are missing to process your eligibility, if you just don't qualify, or what happen, so you know if you can count on this in the future and for this bill too; otherwise you will be responsible for it. Many offices will set up payment plans though if it turns out you do not have coverage and call to work something out with the doc office if you are not covered.

I would go to the doctor and see what happens, let MassHealth be in charge of its own business. If something is wrong, it will be one doctor's bill you cannot pay and can ignore or pay slowly, etc. No doctor is going to see you without your being able to pay and that's what it is like now? So I do not see that you have anything to lose.

Very good advice!

After several calls to MassHealth to confirm that MassHealth Standard will cover my doctor's visits (and several confirmations from MassHealth that they would), today I learned that they won't.

Today I called MassHealth for a completely unrelated reason, and happened to get connected with a very experienced MassHealth employee. Out of nowhere, she warned me that like many other disabled people, I had fallen into a crack in the system. Because I have Medicare Part A and NOT Medicare Part B, NO STATE RUN health insurance plan whatsoever will cover my doctor's visits. This is because state run insurance plans are always listed as secondary insurance to Medicare, regardless of which "parts" of Medicare coverage one has.

She said that in her experience, many disabled people in Massachusetts initially have this problem. They cancel Medicare Part B because it costs over $100 a month, compared to less expensive MassHealth premiums. People have no idea that they will lose MassHealth's doctor visit coverage if they cancel Part B. No one warns them and it's not a logical question to ask. Then people get stuck without insurance for doctors visits.

MassHealth tried to remedy this for me by providing me with MassHealth Standard. What was overlooked (several times) is that MassHealth Standard will NOT cover doctors visits for people who have Medicare Part A without Medicare Part B.

****When I posted the question in the OP, I had a completely different concern about not qualifying for MassHealth.