The Commonwealth Care Health Insurance Program is run by the Commonwealth Health Insurance Connector Authority (known as the "Connector"). This program connects eligible Massachusetts residents with approved health insurance plans and helps them pay for health insurance coverage through the plans.
The Connector helps Commonwealth Care members join a health plan and find providers that meet their needs. A health plan works together with a certain group of providers, hospitals, and other health-care professionals to provide specific health-care services.
Commonwealth Care pays the total cost of health insurance for qualified individuals who meet certain income and/or other guidelines and helps pay for the cost of insurance for other qualified individuals who meet the criteria established by the
Please visit the Commonwealth Connector to help you determine your eligibility for Commonwealth Care based on your income.
You can choose NHP when you first sign up for Commonwealth Care. If you do not choose a plan within 14 days, you may be auto-assigned to another plan. However, you still have 60 days from your intial signup date to switch to NHP. Just call The Connector Monday through Friday from 8 a.m. - 5 p.m. at 1.877.MA.ENROLL (1.877.623.6765), and ask to become a member of Neighborhood Health Plan.
Individuals who receive an approval notice for Commonwealth Care will get an enrollment packet from the Connector.
To Enroll in the plan:
Your premiums and copayment costs will vary depending on your income and city of residence.
If your Commonwealth Care health insurance requires you to pay a premium for your Commonwealth Care coverage, please follow the directions provided to you by the Connector Authority for paying your premiums. Please do not send premium payments to NHP. Each month you will receive a bill from the Connector Authority. You must pay this bill every month for your health benefits to continue. You may apply for a waiver or reduction of your premiums payments; you may also qualify for a premium payment plan.
If you have any further questions about making premium payments or would like to learn more about premium payment options, please contact Commonwealth Care Customer Service Center at 1-877-MA-ENROLL or 1-877-623-6765, Monday through Friday from 8:00 a.m. to 5:00 p.m.
For people with partial or total hearing loss, please call TTY: 1-877-623-7773. Commonwealth Care Customer Service can also answer questions you have about your premium bill.
Call a Commonwealth Care Customer Service Representative to get help finding a new doctor in your area. Our Provider Directory lists Primary Care Providers in the NHP Commonwealth Care network.
After your health plan has been chosen and your enrollment starts, you will have 60 days to change your health plan if you feel a different health plan may better meet your needs. After the 60-day period has passed, you may change your health plan only for the following reasons:
In most cases, your health-plan coverage will start on the first day of the month following your health-plan selection. For example, if you select a plan on October 12th, the effective date of your coverage would be November 1st. However, if you choose your health plan on the last two days of each month, your enrollment may not start until the first day of the second month following your plan selection. For example, if you select a plan on October 31st, the effective date of your coverage would be December 1st. It is best to choose a health plan as soon as possible after you receive your Commonwealth Care enrollment packet.
If necessary, you will be able to use the Health Safety Net (HSN) until the effective date of your health-plan enrollment. On the date of your Commonwealth Care health-plan enrollment starts, your health services will be provided by your health plan, not the HSN.
The Health Connector can perform redetermination to evaluate whether a member meets the eligibility criteria for a particular plan or plans. Redetermination may happen annually, or whenever major plan changes or eligibility criteria changes are implemented.
Your Plan Type 1 dental benefits are provided by Doral Dental. As a member you are eligible to receive dental benefits that include restorative, preventative, radiography, diagnostic, prosthodontical, and oral surgery with no co-payment. For all routine dental questions, you should call Doral at 1-800-207-8214 or visit www.doralusa.com
You are eligible for the routine vision care benefit as soon as you become an NHP Commonwealth Care member. For more information about the Spectera vision benefit, please visit our Spectera benefit information page.
