Episode Transcript
[00:00:00] Speaker A: Welcome back. The open enrollment period is underway for the Massachusetts Healthcare Connector program, and the folks at Manit Community Health center here in Quincy can help you with that. So Shirley Farhardo and Ken Moore are with us this morning to tell us a bit more about Manit and about how the program itself may impact you.
[00:00:18] Speaker B: Welcome.
[00:00:18] Speaker A: Happy New Year.
[00:00:19] Speaker B: Hi, Joe.
[00:00:19] Speaker A: Thank you. Happy New Year.
[00:00:20] Speaker B: Thanks for having us. Happy New Year.
[00:00:21] Speaker A: Pleasure. Ken, welcome back.
[00:00:22] Speaker B: We've had you before.
[00:00:23] Speaker A: Yes. And Shirley, welcome for the first time, but hopefully not the last time.
[00:00:27] Speaker C: Thank you.
[00:00:28] Speaker A: We'll probably start with you, if that's okay. Yes, of course. Give us a little bit of an overview for folks who don't know.
It's been only 50 years or so. Right.
[00:00:35] Speaker C: Man.
[00:00:35] Speaker A: @ community health center, tell.
[00:00:36] Speaker C: Us. Yes, of course.
So we are a federally qualified community health center. We offer primary care for families and individuals of all ages. But we also have integrated services like behavioral health. We have nutrition services. We have chronic disease management, care management. We also have radiology vision center on site. We have an on site pharmacy, which is pretty amazing.
So we do a little bit of everything. We have navigation that can help with insurance. We have community health specialists that can help connect people to social services in the community. So our goal really is to be able to take care of the individual as a whole and be able to tackle anything that could be affecting someone's health.
We have a couple of different sites. We have four different sites in the Quincy area. We have one in hall, one in Attleboro, two in Taunton, and I think I'm in Braintree.
Yes. And we also do for some of. Of our programs, we go into off site.
[00:01:37] Speaker A: Locations. Sure. I know you've been at the Kennedy center here in Quincy. Yes. Presenting different specialty programs. There's a very active mental health counseling portion of Manit as well. I know that folks should look.
[00:01:48] Speaker C: Into. Yeah, we're big into behavioral.
[00:01:49] Speaker A: Health. Yeah. And we should mention it's available to anyone, right? There's.
[00:01:53] Speaker C: No. It is available to anyone.
[00:01:54] Speaker A: Yeah. Yeah. Some people may have an impression that a community health center is only for folks of certain.
[00:02:00] Speaker C: Incomes. No, no, no. We're open to anyone in the community who's looking for.
[00:02:03] Speaker A: Care.
Except both public and private insurance, too.
[00:02:06] Speaker C: Right? Yeah.
[00:02:07] Speaker A: Absolutely. So just to kind of lay the groundwork there. So you're available about how many patients do you serve, roughly? Do you have any.
[00:02:14] Speaker C: Idea? Oh, I don't know that number off the top of my head, but I mean, we're in the thousands. We serve a lot of people and still Taking on welcoming new patients. So anyone who's looking for care, we welcome.
[00:02:28] Speaker A: You.
Sure. And are there also positions available at manit, do you know, for healthcare.
[00:02:33] Speaker C: Providers? Yes, we are always welcome. And providers, Providers, nurses. We have positions available for care managers, community health specialists. We do have positions available which people can go into our website, managechc.org and go into the career section. They'll be able to see a list of any open.
[00:02:53] Speaker A: Positions.
[00:02:54] Speaker B: Okay. All.
[00:02:54] Speaker A: Right. Very good. But as I mentioned earlier, we're in the middle of the open enrollment.
[00:02:58] Speaker B: Period.
[00:02:58] Speaker A: Right. For the Mass Health care connector program. That's where Ken comes in. Because you are a certified navigator and to help folks kind of feed through that process, which can be a little daunting at.
[00:03:10] Speaker B: Times. It can be a little daunting, yes. Yes. So I am a navigator at MANIC community health center.
Basically, open enrollment time is now from November 1st to January 23rd.
And it's very important to do everything before the 23rd, because in case if you have to are on a connected care plan or a health connected plan, you have to pick and pay for that plan before the 23rd of the month. So you'll be on for the 1st of next month on your connected care.
[00:03:37] Speaker A: Plan. Okay. Okay. So time is of the.
[00:03:38] Speaker B: Essence. Time is of the essence. Time to come and see us.
[00:03:40] Speaker A: Now. Okay. What is the Massachusetts Healthcare Connector.
[00:03:44] Speaker B: Ken? So the health connector is basically the marketplace where people would come in and they would apply for state health insurance, either masshealth or the health Connector. So there's masshealth connector care plans as well as health connector plans. So the application that we submit in would evaluate you for all three of those plans and let you know what plans you have available, the.
[00:04:09] Speaker A: Prices. Okay. And then you help them kind of navigate what would best fit their.
[00:04:13] Speaker B: Needs. Yes. So when people book an appointment at manit, they get an hour consultation. We would sit down with them, we'd get into their profile on health Connector, and we would update their family size, income, and immigration status. And then it would give us a determination of what plans they're eligible for for them or for their family and what the prices would.
[00:04:34] Speaker A: Be. Okay. All right. And through the healthcare Connector, can you get either the public program, the Medicaid, or private programs as.
[00:04:42] Speaker B: Well? Oh, no, it would just be basically plans that are offered through the.
[00:04:47] Speaker A: State.
[00:04:48] Speaker B: Gotcha.
[00:04:48] Speaker C: Yes.
[00:04:48] Speaker A: Okay. I didn't realize there was more than one. So how many are.
[00:04:51] Speaker B: There? How many.
[00:04:52] Speaker A: Plans?
[00:04:52] Speaker B: Yeah. Oh, my goodness. I mean, under the connected care, that could be like maybe eight different plans. Under the Health Connector that if not, many more could they. The Health Connector plans are sort of. They go and tear. So you could do bronze, silver, gold, platinum for the Health Connector, but those are plans that don't offer advanced premium tax credits, so they're a little bit more on the higher side with deductibles.
The Health Connector offers connector care plans, which are affordable health insurance plans that could start at $0 a.
[00:05:23] Speaker A: Month. I.
[00:05:24] Speaker B: See.
[00:05:24] Speaker A: Okay. Now, are there certain guideline that folks have to meet in order to qualify for those.
[00:05:29] Speaker B: Programs? Yeah. So when you come in during the consultation, you would want to definitely bring family information as far as names, socials, dates of birth, stuff like that. Income documentation and citizenship documentation. I would put all of that information into the portal and it would let us know what they're eligible for. And some people could be eligible for MassHealth. Some people could be eligible for the ConnectiCare or the Health Connector. It could vary between the members of the.
[00:05:54] Speaker A: Family. We really need someone like.
[00:05:55] Speaker B: You.
I'm here for you, my friend. I am here for you. It's definitely not. Not the easiest thing to navigate, but we. We try to make it extremely easy so it's no stress and pressure on.
[00:06:05] Speaker A: You. Okay. All right. Now, there's been a lot of talk lately about the end of the federal subsidies from the Affordable Care.
[00:06:12] Speaker B: Act.
[00:06:12] Speaker A: Yes. How is that impacting the Massachusetts Health Care Connector.
[00:06:16] Speaker B: Program? So the advanced premium tax credits basically are expiring or have expired. And now in 2026. And the advanced premium tax credits were put together back in 2021 to help offset and lower prices for premiums that people would be facing.
And so the big beautiful bill took that away from us as of 2026. But I did hear that Governor Haley in the administration as of yesterday stated that they were going to be offsetting that premium by donating, I believe, investing, should I say, $250 million to offset the effect advanced premium tax credit. So I just would like to say thank you to the Haley administration. That is so big for so many people in Massachusetts. It's going to make amazing savings. Thank you very.
[00:07:09] Speaker A: Much.
I have the release right here from the governor's office coming from the Commonwealth Care Trust Fund.
You know, she did caution that it's just for one year. So this is just kind of a temporary.
[00:07:20] Speaker B: Fix. It would definitely take a lot to fund. I mean, what the federal government has been doing for people by offsetting the advanced premium tax credits. But even a year for people to save and maybe prepare for the next year. Is still a blessing, so thank.
[00:07:33] Speaker A: You. Okay. And it goes on to say, just in terms of eligibility, the threshold applies to an individual who earns up to $62,600 or a family of four earning up to $128,600. So if you meet those thresholds, you would.
[00:07:50] Speaker B: Qualify. You would qualify, yeah. And that's really big because not only is the premium low, but it usually comes with no deductibles. And we all.
A regular deductible could be two, three grand, but for a family, it could be seven, eight, nine grand. And that's just amazing.
[00:08:05] Speaker A: Savings. Yeah, absolutely. So there will be a slight increase in their monthly premium, but not as much as it would have been without this assistance from the state.
[00:08:15] Speaker B: So.
[00:08:15] Speaker A: Good. That's.
[00:08:15] Speaker B: Huge. So that's great.
[00:08:16] Speaker A: News. So were you seeing that kind of manifest.
[00:08:19] Speaker B: Itself? Oh, I've seen some astronomical.
[00:08:22] Speaker A: Bills.
[00:08:22] Speaker B: Really.
I've seen people come in with a $91 monthly premium, and their premium in 2026 was going up to eleven hundred.
[00:08:32] Speaker A: Dollars. Oh, my.
[00:08:32] Speaker B: Really? And the only thing that person would have been able. Eligible for now would be either MassHealth Limited or MassHealth Health Safety Net, which is an assistance program. So big changes for.
[00:08:44] Speaker A: People. So there's significant circumstances and consequences for the actions that have been.
[00:08:51] Speaker B: Happening.
[00:08:51] Speaker A: Absolutely. Folks need to be aware of now, folks have been enrolled in the program, Ken, before. Do they have to.
[00:08:57] Speaker B: Reapply? Yeah, so people should reapply yearly. Like they would send out a renew form to people's homes and say, you know, we're going to give you a certain amount of time to come in, update your family size, income, and immigration status to make sure that you're eligible for the next.
[00:09:11] Speaker A: Year.
[00:09:11] Speaker B: Okay. But they did say in 2026, maybe late 2026, that there were going to be changes in open enrollment. The renewal process could be every six months. So we're still waiting to hear more on that and when it's gonna maybe.
[00:09:24] Speaker A: Happen.
So would folks be notified about.
[00:09:27] Speaker B: That? Oh, yes. Way in advance. Yes.
[00:09:29] Speaker A: Yes.
Just gonna say they can't make these.
[00:09:31] Speaker B: Changes. Not overnight. No. They would definitely give people ample information and when they would need to come.
[00:09:36] Speaker A: In.
[00:09:37] Speaker B: Okay. All.
[00:09:37] Speaker A: Right. And I guess we should. A couple of things. We should distinguish. First of all, this is not the SHINE program.
[00:09:42] Speaker B: Right? No, no.
[00:09:42] Speaker A: No. Separate from the SHINE.
[00:09:43] Speaker B: Program. Yes, definitely.
[00:09:44] Speaker A: Okay. What is the.
[00:09:45] Speaker B: Shine? So SHINE is serving health insurance needs of everybody, and it's basically for people who are turning 65 getting into Medicare or people who may be under 65 with an injury, illness or disability that's going to last more than 12 months, they would be eligible to come see a shine.
[00:10:01] Speaker A: Rep. Okay, so that's separate from the health care.
[00:10:04] Speaker B: Connector.
[00:10:04] Speaker A: Yes.
[00:10:05] Speaker B: Okay.
[00:10:05] Speaker A: Yes. And there is a hotline, navigation hotline at Manit that folks can.
[00:10:10] Speaker B: Call. Yes, we do. Yes.
It's an amazing number. We've been getting a lot of great calls, you know, and it's sort of a way of giving people a little bit of relief, you know, over the phone before we can get into the big.
[00:10:23] Speaker A: Meeting. So this is a live person that will, they'll talk.
[00:10:25] Speaker B: To. Oh, yeah, okay. Oh, yeah. We get right back in touch with them. We have so many different navigators that are waiting to hear from.
[00:10:31] Speaker A: You. Okay, we're on the screen there.
[00:10:33] Speaker B: 857-403-1557.
[00:10:36] Speaker A: Absolutely. Or through the email as well. Through the website as well. And another thing we should point out, you don't have to be a man of patients.
[00:10:42] Speaker B: Right? Absolutely not. No, no. And all the different manic communities that we're in, communities that Manit is in, you can make an appointment. You don't have to be a manned patient. We'd love for you to be a manned patient if you're looking for services. And you could be, you definitely could be. But we're more focused on just making sure that you get into the correct insurance and help relieve a little bit of that stress that's going.
[00:11:03] Speaker A: On. Yeah, absolutely. You mentioned stress. Surely Mana does have a program, right, to help folks deal with stress related.
[00:11:11] Speaker C: Issues? Of course, yeah. If people are stressed and they are looking for therapy or someone to talk to, they can tap into our behavioral health services if they're looking for.
[00:11:22] Speaker A: That. Yeah, absolutely.
Are you seeing that, you know, come to fruition, Amanda, are folks coming to you with those.
[00:11:28] Speaker C: Problems? Yeah, yes, absolutely. I think in general, people are going through a stressful time.
So for any of our patients, we want to make sure that they're aware of all of the services that we have available and as they communicate to us, whether it is when they meet with the navigators, when they meet with our community health specialists or with any of our providers, we want to make sure that they know that we do have clinicians available that they're able to talk to if.
[00:11:50] Speaker A: Needed. Yeah, absolutely.
So, Ken, when somebody sets up a meeting. Yes. And they physically come in.
[00:11:56] Speaker B: Right.
[00:11:56] Speaker A: Yes. Sit.
[00:11:57] Speaker B: Down. Meet with you.
[00:11:58] Speaker A: Yes. Take us to what that looks.
[00:12:00] Speaker B: Like. Oh, it's a fun time.
Basically, you really get one on one with a person. You Know, I mean, they come in and their main issue could be health insurance, but then we find out more things about them, you know. So basically we will sit down, really just get to know you, find out your family situation, find out your income situation, immigration status update, everything for you and walk you through it.
And then once all the information is in the system, I would present the plan that they're eligible for. I would explain the plans, make sure that their primary care doctor is in the plan. Oh, that's important, Very important.
And just make sure that they're comfortable with the choices that they're going to be.
[00:12:35] Speaker A: Making.
After that, what happens? How long does.
[00:12:37] Speaker B: That. After that, they would wait for a letter? Well, usually, honestly, by the end of the meeting, I can let you know what plan you're eligible to get into.
If it is a MassHealth plan because of the income and family size, then you would be on possibly as of that day with MassHealth, if it is a connected care plan.
Usually if there is a premium involved. All of the connected care plans or health connector plans start on the first of the month. So if you do pick a plan that day with me, we would maybe book another appointment for you to come in to make the payment, because you sort of can't pick and pay at the same time at the same day because it has to register. So once that happens, you come in with me, we'd make the payment online and then at that moment, I'd give you a confirmation number from them showing that it was paid by the 23rd of the month. And then for the 1st of the month, you will be enrolled in whichever health insurance plan that you chose and you'll receive your card and your welcome booklet and.
[00:13:35] Speaker A: Everything. I was going to ask about.
[00:13:36] Speaker B: You. Oh.
[00:13:37] Speaker A: Yeah. So you get a card just like a private.
[00:13:38] Speaker B: Plan. Oh, yes. Yeah. Oh, there's a lot of great plans out there. You know, they have Wellcare, Tufts. I'm sorry. Well, since Tufts, Fallon, Blue Cross, there's so many great plans. All of the great plans.
[00:13:49] Speaker A: Yeah. And is it good for. That's just one year, is that.
[00:13:51] Speaker B: Right? That is for one year. So definitely the connector would send out review forms or notices to say, please go to your local navigator, update your information at that time of the year and you would really want to do it when they say so in a timely manner because you could either get less coverage if you don't renew in time or get a loss of coverage if you don't. We could be cancelled then, right? Yeah. So it's best to be proactive with it. So that way there's no. Because when you really need insurance, you need it to be paid.
[00:14:18] Speaker A: Well.
[00:14:18] Speaker B: Right. So it's best to get ahead of it and make sure you habit for the.
[00:14:22] Speaker A: Year. Now, if somebody's situation changes during their coverage period and they no longer qualify, what happens.
[00:14:29] Speaker B: Then? Well, if somebody, it's good. If you have a change in your family size, like if a kid leaves for being of age, or if there's a divorce or a death or anything like that, it's definitely good to come in as soon as possible to update that information so it can reflect what you should really be on.
And it could go from a health connector plan to a connector care plan or to a masshealth plan. It could definitely vary with the changes that you come in. Okay. All.
[00:14:53] Speaker A: Right. So it's very fluid, but there are options.
[00:14:55] Speaker B: Available. You can come in any time of the.
[00:14:57] Speaker A: Year. Oh, so that's.
[00:14:58] Speaker B: Important. Yeah, any time of the year to make a.
[00:14:59] Speaker A: Change.
[00:15:00] Speaker B: Okay. So you don't have to have. It doesn't have to be open enrollment or you don't need a special enrollment period to do that. Like if you move. Definitely. Once you establish come update your address. If you lose a job, you come in, update with the new pay stubs. Once you get a full weeks of pay because some people go to work and they do a few hours to get used to the job, then they start a few weeks later. 40 hours. Once you get full 40 hour check, you want to come in and present that so we can update your.
[00:15:26] Speaker A: Information.
[00:15:27] Speaker B: Okay. And. Or if your immigration status changes, if you're working towards your green card and it's been that, it's been that time that you've received it, you definitely want to send any immigration status in that you have as soon as.
[00:15:41] Speaker A: Possible.
[00:15:41] Speaker B: Okay.
[00:15:41] Speaker A: Yeah. What about like a job.
[00:15:42] Speaker B: Loss?
Definitely job loss. Well, if you lose a job, you could either be on maybe a connected care plan where you maybe don't have to pay a premium or. Or if your income is low enough, you could possibly be on a mass health.
[00:15:56] Speaker A: Plan.
[00:15:56] Speaker B: Okay.
[00:15:56] Speaker A: Yeah. So there's really no reason not to have some kind of.
[00:15:59] Speaker B: Coverage. Oh, no, there's a lot of amazing coverage in Massachusetts. Everybody for.
[00:16:04] Speaker A: Everybody. And I'm glad you pointed out that changes can be made any time of year. I think sometimes there's a misconception that I have to do this before January 23rd, otherwise I'm.
[00:16:12] Speaker B: Out. Right. That's a case.
Yeah. I mean you can come in anytime to update anything but definitely when you hear that it's open enrollment time or you get those letters, you definitely want to act on that as.
[00:16:20] Speaker A: Well. Well, all right. So reach out either the hotline or the websites or, you know, just stop by one of the.
[00:16:27] Speaker B: Offices. Please.
[00:16:28] Speaker A: Do. And see what's. What's available. Shirley, anything else you'd like to.
[00:16:31] Speaker C: Add?
No, just to continue emphasizing that our navigators are available for anyone in the community, thank goodness. You can schedule. Right? You can schedule an appointment ahead of time, or you can just walk into one of our sites and we'll always.
[00:16:42] Speaker B: Accommodate. Absolutely.
[00:16:43] Speaker A: Great. Thank you.
[00:16:44] Speaker C: Both.
Thank you for having.
[00:16:46] Speaker A: Us. You're very welcome. Please come back.
[00:16:47] Speaker B: Too. Oh, yes, we.
