Alyssa Lane
If you want to check the status of your MassHealth insurance, you can do so by visiting MyServices.mass.gov. Here, you can review your MassHealth enrollment information, such as the name of your plan and the date your plan started. You can also check the status of Requests for Information (RFIs) and see if any responses you've submitted have been processed. Another way to check the status of your MassHealth claim is through the Provider Online Service Center (POSC). If you are a member, you may also use the MyServices mobile app, which is available in six languages.
| Characteristics | Values |
|---|---|
| Who can check the status of MassHealth insurance? | The head of household (the person who signed the application for benefits) |
| Where to check the status of MassHealth insurance | My Account Page (MAP), MyServices, Provider Online Service Center (POSC), MassHealth Dental Provider Portal, Pharmacy Online Processing System (POPS) |
| What can be checked on MAP? | Health Assistance benefit information, including the status of documents and notices, personal information, case status, health insurance and health assistance program information, program eligibility information, eligibility notices, list of documents sent to MassHealth, status of submitted applications, and more |
| What can be checked on MyServices? | MassHealth enrollment information, such as the name of the plan and the date the plan started, status of Requests for Information (RFIs), and more |
| What can be checked on POSC? | Claims that were submitted to MassHealth, and the status of the claims |
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What You'll Learn
Checking the status of documents sent to MassHealth
To check the status of documents sent to MassHealth, you must be a Massachusetts resident who is currently receiving health benefits and the head of household (the person who signed the application for benefits). If you meet these criteria, you can review your health assistance benefit information, including the status of documents and notices, on the My Account Page (MAP).
On the My Account Page, you can see the status of documents you have faxed or mailed to MassHealth, such as whether they've been received or processed. The "Documents" area displays in MAP when viewing health insurance information. Some of the information in the My Account Page is updated overnight and may not be available at certain times. The following information is available in the Documents area of MAP:
- Document Category, e.g., HCR MBR (such as ACA Paper Application, ACA Referral Application, etc.)
- Verification (such as income, citizenship, etc.), General Maintenance (such as Change of Address, etc.), Traditional Maintenance, Traditional SMBR
- Status of document: Processed (has a disposition) or Unprocessed (does not have a disposition)
- Date Received - faxed documents typically display within 48 hours, mailed documents within 1 week
You should see one line in the list for each individual document or group of documents mailed or faxed. If multiple documents were sent in one fax or mailing, you will only see the name of one of the documents. Therefore, it's a good idea to check the list first for a "Date Received" around the time you think it was sent in, rather than first checking by "Document Category."
Additionally, MassHealth offers a web tool and mobile app called MyServices, which is available in six languages: English, Spanish, Brazilian Portuguese, Simplified Chinese, Vietnamese, and Haitian Creole. MyServices allows MassHealth members to review eligibility notices and voter registration notices sent by MassHealth.
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Reviewing eligibility notices
To check the status of your MassHealth insurance, you can use the My Account Page (MAP) to review your health assistance benefit information. This includes reviewing eligibility notices.
An eligibility notice lets you know if you meet the rules to get MassHealth benefits or coverage through the Massachusetts Health Connector. You can review eligibility notices sent by MassHealth on the MyServices web tool or mobile app. MyServices is available in six languages: English, Spanish, Brazilian Portuguese, Simplified Chinese, Vietnamese, and Haitian Creole.
To access the My Account Page, you must be a Massachusetts resident who is currently receiving health benefits and the head of the household (the person who signed the application for benefits). If you are the head of the household and have never received health assistance benefits yourself, you will not be able to access health benefit information for other household members using the My Account Page.
On the My Account Page, you can see the status of documents you have faxed or mailed to MassHealth, such as whether they've been received or processed. The "Documents" area displays in MAP when viewing health insurance information. Some of the information in the My Account Page is updated overnight and may not be available at certain times. The following information is available in the Documents area of MAP:
- Document Category, e.g., HCR MBR (such as ACA Paper Application, ACA Referral Application, etc.)
- Verification (such as income, citizenship, etc.)
- General Maintenance (such as Change of Address, etc.)
- Traditional Maintenance
- Traditional SMBR
- Status of the document: Processed (has a disposition) or Unprocessed (does not have a disposition)
- Date Received - faxed documents typically display within 48 hours, mailed documents within 1 week
If you applied via mail, fax, or in-person, you will receive a written notice about your eligibility. MassHealth will contact you if they need more information. If you have completed your Massachusetts Application for Health and Dental Coverage and Help Paying Costs and MassHealth has determined that you qualify for coverage, they will let you know if you need to enroll in a health plan.
To be eligible for MassHealth, you must be a resident of Massachusetts and financially eligible. MassHealth offers different types of coverage based on your family situation and age. You can visit a Massachusetts Health Connector Walk-In Center or call the Health Connector Customer Service Call Center to get help with your application and questions about your eligibility.
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Checking the status of submitted applications
To check the status of submitted applications for MassHealth insurance, you can use the Virtual Gateway's My Account Page (MAP). This is available to members who are the head of the household (the person who signed the application for benefits).
To use MAP, simply follow the instructions provided on each screen. You can search for your information by filling in any blank boxes on the first screen and then typing in your Member ID number (found on your MassHealth Member card or Notices sent to your household).
Once you've entered your Member ID number, you can select your name at the bottom of the page to view the status of submitted applications, as well as program eligibility information, next steps, eligibility notices, and a list of documents sent to MassHealth.
The "Documents" area of MAP displays when viewing health insurance information, and you can see the status of documents you've faxed or mailed to MassHealth, such as whether they've been received or processed. Faxed documents typically display within 48 hours, while mailed documents can take up to a week.
You can also check the status of your MassHealth claim on the Provider Online Service Center (POSC). This is available Monday through Friday from 8 a.m. to 5 p.m. You can contact MassHealth Customer Service for Providers at 711 or via email at [email protected].
Additionally, you can check the status of Requests for Information (RFIs) and review your MassHealth enrollment information, such as the name of your plan and the date it started, through the MyServices web tool and mobile app. MyServices is available in six languages: English, Spanish, Brazilian Portuguese, Simplified Chinese, Vietnamese, and Haitian Creole.
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Checking the status of Requests for Information (RFIs)
To check the status of your MassHealth insurance, you must be a Massachusetts resident currently receiving health benefits and be the head of your household (the person who signed the application for benefits).
You can check the status of Requests for Information (RFIs) by visiting MyServices.mass.gov. Here, you can review your MassHealth enrollment information, such as the name of your plan and the date your plan started. You can also check the status of RFIs, including whether any response you submitted has been processed.
If you are the head of your household, you can also use the Virtual Gateway's My Account Page (MAP) to view your case status online. You can find your Member ID number on your MassHealth Member card or Notices sent to your household. After logging in, type in your Member ID number to see Health Insurance and Health Assistance Program Information. Then, select your name at the bottom of the page to view program eligibility information, next steps, eligibility notices, and a list of documents sent to MassHealth.
Additionally, the Provider Online Service Center (POSC) allows providers to check the status of claims submitted to MassHealth. Providers can log on to the POSC and search for claims individually, by batch, or by reviewing the MassHealth Remittance Advice (RA). The 276/277 HIPAA-compliant electronic transaction is the standard for claim status inquiries, allowing providers to determine if a claim is paid, denied, or suspended.
For further assistance, you can contact MassHealth Customer Service for Providers at TTY/TDD: 711 or email [email protected].
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Checking the status of claims
Checking the status of your MassHealth insurance claims can be done in several ways. Firstly, you can check the status of your claims by visiting the Provider Online Service Center (POSC). Here, you can search for claims individually, by batch, or by reviewing the MassHealth Remittance Advice (RA). The 276/277 HIPAA-compliant electronic transaction is the standard for claim status inquiries, allowing you to determine if a claim has been paid, denied, or suspended.
To submit a request to check your claim status, you can upload a 276 batch file. Within 2 to 24 hours, MassHealth will generate a 999 acknowledgment file if the 276 request passes pre-compliance. This file will contain data indicating the status of your transaction sets. You can download and review the 999 file from the POSC for each 276 file submitted. The status indicators in the file will tell you whether your file was accepted, rejected, or partially accepted.
Additionally, you can check the status of your MassHealth insurance claims by contacting MassHealth Customer Service for Providers. They can be reached via phone at (800) 841-2900 or by email at [email protected]. Their operating hours are Monday through Friday from 8:00 a.m. to 5:00 p.m. For TTY/TDD access, you can also call 711 during the same hours.
If you are a dental provider, you can check the status of your claims by visiting the MassHealth Dental Provider Portal. Similarly, if you are a pharmacy provider, you can access the Pharmacy Online Processing System (POPS).
Finally, you can review your health assistance benefit information, including the status of documents and notices, by accessing your My Account Page (MAP). This option is available to Massachusetts residents who are currently receiving health benefits and are the head of their household (the person who signed the application for benefits). Please note that certain information on the MAP may not always be available, as it is updated overnight.
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Frequently asked questions
You can check the status of your MassHealth insurance by visiting the My Account Page (MAP) on the Virtual Gateway. Here, you can review your health assistance benefit information, including the status of documents and notices.
To check the status of your MassHealth insurance, you will need your Member ID number, which can be found on your MassHealth Member card or Notices sent to your household.
MyServices is a web tool and mobile app for all MassHealth members. It is available in six languages: English, Spanish, Brazilian Portuguese, Simplified Chinese, Vietnamese, and Haitian Creole. With MyServices, you can review your MassHealth enrollment information, eligibility notices, and more.
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