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detour1
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Default Oct 01, 2017 at 01:55 PM
  #1
Hi ,I am 22 years old and only work 2 hours 3 days and sometimes 4 and i still live with my parents and use their insurance but also have mass heath which i also use but i belive it is the secondarily i have bluecross and OptumRx for the medication ,but i my parents told me at a certain age i cannnot get coverage anymore i dropped out at a certain age ,but i do get ssi but need something that will cover ,doctor visit ,pcdoc visit ,and meds that will cover seroqel ,generic and mirtpazine ,and lunseta ,which is generic as well lunesta is mostly covred by one insurance 10.00 co pay ,what are some options or programs can help me
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Default Oct 02, 2017 at 03:01 AM
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It seems to me that you should be covered under Mass Health. On the Mass Health website it indicates that it includes Medicaid and CHIP. I'm guessing that you are under CHIP and there is an age restriction there and that you probably now have to apply for Medicaid instead.

I would think that would be all that you would need. It should cover everything, but you should confirm that.

I would look at your options on this site:

MassHealth

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detour1
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Default Oct 02, 2017 at 04:43 AM
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Originally Posted by reb569 View Post
It seems to me that you should be covered under Mass Health. On the Mass Health website it indicates that it includes Medicaid and CHIP. I'm guessing that you are under CHIP and there is an age restriction there and that you probably now have to apply for Medicaid instead.

I would think that would be all that you would need. It should cover everything, but you should confirm that.

I would look at your options on this site:

MassHealth
Okay thank! not sure how to apply ,i probably will ask my dds worker for options but thanks again
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Default Oct 08, 2017 at 12:01 AM
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Anymore who gets SSI, automatically qualifies for Medicaid. (except in Illinois or Ohio.) Do you have Medicaid?

If you get MassHealth, then you have Medicaid. MassHealth is the name of Medicaid in Massachusetts. Since you seem to have Medicaid, I don't see why you would need any other kind of health insurance.

MassHealth also runs the CHIP program, which covers kids to age 19. You're too old to get that. So the MassHealth program you are under is Medicaid. If you don't have it, go to your Income Support office and apply for it.
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Default Oct 08, 2017 at 04:38 AM
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Anymore who gets SSI, automatically qualifies for Medicaid. (except in Illinois or Ohio.) Do you have Medicaid?

If you get MassHealth, then you have Medicaid. MassHealth is the name of Medicaid in Massachusetts. Since you seem to have Medicaid, I don't see why you would need any other kind of health insurance.

MassHealth also runs the CHIP program, which covers kids to age 19. You're too old to get that. So the MassHealth program you are under is Medicaid. If you don't have it, go to your Income Support office and apply for it.
Hi ,i was told that massheath i got is a secondary ,not sure which one i got it
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Default Oct 08, 2017 at 08:35 AM
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Hi ,i was told that massheath i got is a secondary ,not sure which one i got it
Yes, MassHealth is secondary, while you are on your parents' insurance. But, once you are off your parents' insurance, it becomes primary.

Medicaid (MassHealth) is always the insurance "of last resort." However, once it kicks in, it is about as comprehensive as a health insurance policy can get. It covers everything. So you have nothing, really, to worry about. Plus, Massachusetts tends to fund its Medicaid program more generously than any other state. So what meds and providers it allows you to access should be reasonably close to what you get through your parents' policy. Plus, Massachusetts has one of the best healthcare infrastructures of any state. You've got some of the best hospitals and physicians in the world in your state, so healthcare standards there are high. You can really relax.

Since you've been too old for CHIPS for a few years, I would presume your parents already got you transferred over to adult Medicaid, if that didn't happen automatically, which may have been the case. Ask them to show you your Medicaid and MassHealth cards. If they prefer to hold on to them for you, get copies made. Then carry the copies in your wallet.

I would be surprised, if you have any co-pays at all, once MassHealth becomes your primary. As in other states, MassHealth probably operates through private healthcare networks with which it has contracts. Typically, you would choose from amongst those networks. (Blue Cross and OptumRx may have those contracts. I think OptumRx would be for prescriptions only.) They might differ slightly from each other in which doctors and which meds they steer you towards. As a MassHealth subscriber, you won't be able to get any other insurance (besides your parents'.) And you wouldn't want to.

It sounds like your parents are a bit confused, themselves, or they would have told you that you have nothing to worry about. So do ask your dds worker to help you understand. Your dds worker may not be expert and may have to refer you to a dds supervisor. Or go to Income Support and ask to speak to a supervisor there. Ideally, have your parents sit in on the explanation.
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Default Oct 08, 2017 at 08:42 AM
  #7
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Originally Posted by Rose76 View Post
Yes, MassHealth is secondary, while you are on your parents' insurance. But, once you are off your parents' insurance, it becomes primary.

Medicaid (MassHealth) is always the insurance "of last resort." However, once it kicks in, it is about as comprehensive as a health insurance policy can get. It covers everything. So you have nothing, really, to worry about. Plus, Massachusetts tends to fund its Medicaid program more generously than any other state. So what meds and providers it allows you to access should be reasonably close to what you get through your parents' policy. Plus, Massachusetts has one of the best healthcare infrastructures of any state. You've got some of the best hospitals and physicians in the world in your state, so healthcare standards there are high. You can really relax.

Since you've been too old for CHIPS for a few years, I would presume your parents already got you transferred over to adult Medicaid, if that didn't happen automatically, which may have been the case. Ask them to show you your Medicaid and MassHealth cards. If they prefer to hold on to them for you, get copies made. Then carry the copies in your wallet.

I would be surprised, if you have any co-pays at all, once MassHealth becomes your primary. As in other states, MassHealth probably operates through private healthcare networks with which it has contracts. Typically, you would choose from amongst those networks. (Blue Cross and OptumRx may have those contracts. I think OptumRx would be for prescriptions only.) They might differ slightly from each other in which doctors and which meds they steer you towards. As a MassHealth subscriber, you won't be able to get any other insurance (besides your parents'.) And you wouldn't want to.

It sounds like your parents are a bit confused, themselves, or they would have told you that you have nothing to worry about. So do ask your dds worker to help you understand. Your dds worker may not be expert and may have to refer you to a dds supervisor. Or go to Oncome Support and ask to speak to a supervisor there. Ideally, have your parents sit in on the explanation.
Hi i do carry my own cards ,the only med not covered is lunesta which i got the generic and yes the OptumRx is for prescriptions only but thankyou for your help
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Default Oct 08, 2017 at 08:57 AM
  #8
Explain to your presciber that MassHealth doesn't cover Lunesta and its generic version . . . especially once you are off your parents' policy. The doctor might have free samples you could be given. Some drug companies also offer their drugs at a deep discount to persons who need financial help. Here's a link: https://www.drugs.com/price-guide/lunesta
Scroll down to the section titled "Patient Assistance."
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