MassHealth members in a health plan can change health plans for any reason only during their plan selection period. Once members are in their fixed enrollment period, they can only change their health plan for certain reasons.
These members can change health plans at any time for any reason:
- Children in care or custody of the Department of Children and Families (DCF)
- Youth in care or custody of the Department of Youth Services (DYS)
- Newborns and babies younger than one year old
- Members enrolled in the primary care clinician (PCC) plan
Plan selection period
ACO and MCO health plan members
If you are in an Accountable Care Organization (ACO) plan or Managed Care Organization (MCO) plan, you have a 90-day plan selection period each year. You can change your health plan during this time. MassHealth will tell you when your new plan selection period starts and ends. During that period, you can change health plans for any reason.
- If you want to keep your health plan, you do not need to do anything.
- If you want to change your health plan, you can see plans in your area at Compare plans.
PCC plan members
If you are in the Primary Care Clinician (PCC) plan, you can change to an ACO or MCO at any time. If you change to a health plan other than the PCC plan, you will have plan selection and fixed enrollment periods.
Fixed enrollment period
If you are in an ACO or MCO, when your plan selection period ends you will enter your fixed enrollment period. During this time you cannot change your health plan, except for certain reasons.
You may ask to change your health plan for a special reason. To learn more, read the Enrollment Guide. Or go to http://www.mass.gov/eohhs/gov/departments/masshealth/fixed-enrollment-period.html
You can also call 1-800-841-2900 (TTY: 1-800-497-4648).
Service area exceptions
If the health plan you need is not available in your area, you may be able to submit a request for a Service Area Exception here https://masshealth.ehs.state.ma.us/StateForms/. Or call MassHealth Customer Service at 1-800-841-2900.