Important MassHealth Changes, esp for Harvard Vanguard and Cambridge Health Alliance Patients

[siderea]

(Updated Dec 20)

If you are on MassHealth, and you get your primary care from either Harvard Vanguard (such as the one over the Au Bon Pain) or Cambridge Health Alliance (such as the one next to the defult Elephant Walk outside of Porter Square), there are some VERY BIG CHANGES coming with VERY IMPORTANT CONSEQUENCES.

If you are such a person, you should have received a package in the mail from MassHealth. It's a big white packet with a green stripe down one side. It says on the outside "This package contains important information about your health plan." Sure does. You'll want to read yours.

I just this afternoon called Harvard Vanguard, Cambridge Health Alliance, and MassHealth to get some clarity and make sure I understood the following correctly. (Edit to add 12/20: I have also now spoken to Neighborhood Health Plan, and Tufts Health Plan, which is running the ACO plans described below. I have also done a bunch of research online.)

From March 1, 2018 on, Harvard Vanguard (more accurately, the whole Atrius Health system, of which they're a large part) and Cambridge Health Alliance (edit to add: an a bunch of other, less local, healthcare systems) are cutting over to a new system for MassHealth patients. To continue being a patient there, you will have to be on one particular Atrius-specific or CHA-specific health insurance which no almost no other health care providers take.

That is, if you get your primary care through the Davis Square Harvard Vanguard, you will have to get all your other care from Atrius, too, and a select list of approved hospitals. Your Atrius-specific insurance will not cover care at specialists anywhere else.

This includes psychotherapy and psychiatry. For psychotherapy and psychiatry, there is an additional short list of external approved providers. ( This got long. )