No confusion - state health insurance sign-up is now
The annual open enrollment period for Commonwealth Care, the subsidized state health insurance plan enacted to provide universal access to insurance coverage for all Massachusetts citizens, began on May 25 and extends through June 25.
Island members of Commonwealth Care have the opportunity to choose between one of the two nonprofit managed care organizations the state's Health Connector, the agency that administers the state insurance plan, has approved to provide Island coverage.
Boston Medical Center (BMC) Health Net, the first plan made available to Islanders following the implementation of the state's landmark law in 2006, is not one of those plans.
By law, with some exceptions, all residents of Massachusetts must have health coverage that meets state standards. Commonwealth Care premiums are based on income, family size, and plan coverage. There are currently more than 1,200 residents enrolled in the plan.
For all practical purposes, Islanders who subscribe to Commonwealth Care must choose an insurer that has a contract with the Martha's Vineyard Hospital, the chief provider of health-care services on the Island. There are two choices in the current enrollment period.
Network Health Plan, a managed care organization started by the Cambridge Health Alliance, has offered coverage to Islanders for more than one year. It will continue to do so and has a contract with the hospital.
Neighborhood Health Plan, founded by the Massachusetts League of Community Health Centers and the Greater Boston Forum for Health Action, recently extended its coverage area to the Island. The insurer has signed a contract with the hospital that is effective July 1.
But not BMC Net
BMC's contract with the Martha's Vineyard Hospital expires at the end of this month.
Boston Medical Center Hospital, formerly Boston City Hospital, founded BMC Net in 1997, to offer health care coverage for MassHealth (Medicaid), which provides health care for certain low-income residents, and Commonwealth Care participants.
Tim Walsh, the Martha's Vineyard Hospital CEO, said the hospital decided to end its contract with BMC after the relationship became problematic. In a telephone call Tuesday, Mr. Walsh outlined the reasons for the hospital decision.
Primarily, he said, it was the difficulty Vineyard hospital doctors encountered attempting to place patients in hospitals other than Boston Medical Center Hospital, for instance Children's Hospital Boston and Mass General Hospital.
"When we signed the original contract, we had talked about referrals and the fact that our natural referral pattern is to Mass General, primarily," Mr. Walsh said. "And they assured us they would not interfere with the natural referral processes that are here. It turned out not to be true, because we had a lot of trouble placing people anywhere but BMC."