Changing Your Medicaid Insurance Plan

If you have a Medicaid (MassHealth) insurance plan, please be advised that we only accept Wellsense Boston Children’s ACO as the primary insurance plan. You must be listed with this plan AND have one of our providers listed as your primary care provider (PCP) in order to be seen. If this insurance is listed incorrectly, you will be asked to call the insurance plan to correct the information and obtain a reference number before you are seen.

Children who meet the following criteria can change their plan at any time:

• Children in the care or custody of the Department of Children and Families (DCF)
• Youth in the care or custody of the Department of Youth Services (DYS)
• Newborns and children who are younger than one year old
• Members enrolled in the Primary Care Clinician (PCC) plan

 Children already enrolled with MassHealth can change their plan if:

• Their previously established primary care provider works at Commonwealth Pediatrics

OR

• They are in their 90-day plan selection period, as notified by MassHealth

Children already enrolled with MassHealth cannot change their plan if:

• They have never previously seen a provider that works at Commonwealth Pediatrics

AND

• They are in their fixed enrollment period
  These children CAN change their plan during their annual 90-day plan selection period

It is very important to read all mail from MassHealth carefully, so your child does not experience a lapse in insurance or a change in either their plan or their primary care provider

If your child needs to change their plan, follow these steps before your child’s next visit:

• Call MassHealth at 800-841-2900, Monday through Friday from 8 a.m. – 5 p.m., visit www.masshealthchoices.com, or make an appointment with an Enrollment Assister at www.MAhealthconnector.org/help-center.
• Give your child’s name, date of birth, and current MassHealth information
• Ask that your child be switched to the following plan: Wellsense Boston Children’s ACO
• Identify your child’s Commonwealth Pediatrics provider as their PCP: Dr. Aidette Florimon, Dr. Angelica Espinosa-Louissaint, or Dr. Michelle Lock
• If your child is less than 4 months old, the coverage must be back-dated to their date of birth
• Request the name of the person you spoke to and a reference number
• Record that information on this sheet and call our office manager, Kerrin Blake