If you need health care but cannot afford to pay for it, you may be eligible for Health Safety Net Full, Partial or Secondary benefits. The Health Safety Net services are NOT available at most private physician offices. However, it is available at the Brockton Neighborhood Health Center and at neighboring hospitals in the Brockton area.
What does Health Safety Net cover? What does it not cover?
Health Safety Net (HSN) covers inpatient (overnight), outpatient (walk-in), emergency medical services and now pharmacy. All prescriptions written by our providers or to a referred provider are covered by HSN with a small co-pay.
If your application for medical benefits is approved for HSN, most other medically necessary services performed at the health center will be covered. Unfortunately, physician services at private offices outside of the BNHC are not covered by HSN.
In addition, patients that qualify for Partial HSN are responsible for the lab and hospital charges in full that are processed outside the BNHC up to their deductible amount. Once your deductible is met, you will be eligible for Full HSN benefits.
How do I know if I am eligible for Full, Partial or Secondary Health Safety Net?
- If you are eligible for Limited MassHealth, you will also be eligible for Health Safety Net that those programs do not cover.
- If you are enrolled in MassHealth now, but you were not eligible for medical services at the time of your visit, you may be eligible for HSN for dates prior to that eligibility. Check with our staff so that they can run a REVs for old dates of service.
- If your family income is 200% or less of the Federal Poverty Guidelines, you are eligible for Full HSN.
- If your Family income is 201% to 400% of the Federal Poverty Guidelines, you may be eligible for Partial HSN.
- If your income is up to 400% of the Federal Poverty Guidelines and you have other private insurance, you may be eligible for Secondary HSN for deductibles. HSNO does not reimburse for private or public copays.
- If your income is up to 400% of the Federal Poverty Guidelines and you have Medicare insurance with no coverage for the 20% co-insurance, HSNO will pay up to the patient responsibility.
- At any income level, based on your financial/medical hardship, you may be eligible for HSN or Partial HSN.
Can Immigrants get Full or Partial Health Safety Net?
Yes! Anyone, regardless of his or her immigration status, who resides in Massachusetts, can get Full or Partial HSN.
How do I apply for Health Safety Net?
To apply for HSN you must complete a Massachusetts Member Benefit Request (MBR) at the Brockton Neighborhood Health Center and supply income documentation. Examples of accepted income documentation are: your last Federal tax return, two pay stubs for all family members, a letter from your employer, etc. You can apply for benefits within our Pre-Registration or Intake Departments. Our staff will also help you with any re-determination needs in the future to ensure continuity and lack of disruption of your care.
After I apply for Health Safety Net, how long do I have to wait for an answer?
The Office of Medicaid/Division of Medical Assistance will notify you within 30 days, most times sooner, upon completing a MBR application. By applying, you may receive approval in other public programs. If you do not understand the determination letter, feel free to return to the Brockton Neighborhood Health Center’s Intake Department for clarification. The Health Safety Net approval is noted on the second/back page of the notification letter.
What about other public insurance plans?
The staff at the Brockton Neighborhood Health Center are trained to assist you in many other public insurance plans like: MassHealth, Healthy Start, Children’s Medical Security Plan, and Commonwealth Care. Someone at the Health Center can help you decide the best plan that will meet your health needs. The final determination of program coverage is made by the Office of Medicaid.
Do I have to apply for Health Safety Net every time I need to go to the health center?
No. Your application will be approved for up to a one (1) year period. Once your application for HSN is approved, you will have HSN at all participating health centers and hospitals. HSN does not cover private physician offices or private physicians that read test results. You no longer need to do multiple applications for multiple sites. In fact, it is now a single application for the family unit. How much will I have to pay if I qualify for Partial Health Safety Net?
A reviewer can assist you in your application process. You may be subject to an annual family deductible, as well as, be responsible for a percentage of your office visit charges. Once your application has been completed, you will receive a letter from the Office of Medicaid explaining your deductible amount and percentage due. Laboratory specimens that are forwarded to the hospital are NOT covered under partial HSN.
How do I qualify for “medical hardship?”
People of any income level may qualify for medical hardship if their medical bills are so large that paying them would cause significant financial hardship. To qualify for medical hardship, your medical expenses must exceed a set percentage of gross income listed below.
Income Level | Percentage of Gross Income |
---|---|
0-200% FPG | 10% |
201-300% FPG | 15% |
301-400% FPG | 20% |
401-600% FPG | 30% |
>601% FPG | 40% |
Can I appeal the decision of the health center?
Yes! If you have been denied Full, Partial or Secondary Health Safety Net, you can appeal that decision. To do so, you must send a written complaint to:
Division of Health Care
Finance and Policy
2 Boylston Street
Boston, MA 02116
Or fax appeal to: (617) 210-5820
The Division must notify you in writing of its decision within 30 days of receiving all information from the health center and you.
If you have any further information, please do not hesitate to ask one of our staff. They will be more than willing to help you.