Member Newsletter

MassHealth

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Why annual wellness visits are so important 

Going to an annual exam is one of the most important things you can do to manage your health. These once-a-year checkups give you and your healthcare provider a snapshot of your overall wellness. When you know where your health stands it is much easier to keep track of any changes. As a member of WellSense, your annual visits are covered at no cost to you. The best way to schedule your annual wellness visit is to contact your primary care provider (PCP). If you do not know who your PCP is or want to choose a new one, call Member Services at 888-566-0010.

Your PCP is the healthcare provider

you chose or who was assigned to you by WellSense to help you manage your non-emergency, day-to-day health needs. If you need to see a specialist or have a procedure done, your PCP can help you set up those appointments too.

Your wellness visit is also a great time to ask
your PCP any questions you might have about your health. They can teach you ways to stay healthy and manage your risk for conditions like high blood pressure or diabetes. 
If you need urgent or after-hours care
call our 24/7 Nurse Advice Line at 800-973-6273. Call 911 if you need emergency care for chest pain, bleeding that won’t stop, poisoning or drug overdose. For a mental health and/or substance abuse crisis, call our hotline, 24/7 at 888-217-3501.

Stay safe from the flu and COVID-19 this winter

Winter is peak flu season, so you may be wondering how to stay healthy while more and more people return to “normal.” Though many of the public safety measures in response to COVID-19 have gone away, there are still things you can do to avoid getting sick.

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Flu vaccine

The best way to protect yourself during flu season is to get a yearly flu vaccine. Flu vaccines are safe and effective. They can help you avoid getting the flu. They also help you not get as sick if you do catch it. Some people are at a higher risk of having serious flu complications than others. Getting a flu shot is especially important for children under 2 years old, seniors over 65 years old, those with chronic health conditions and those who are pregnant.

You can ask your usual healthcare provider about getting vaccinated against the flu at their office. You can also get flu vaccines at any pharmacy or clinic in your community that accepts your WellSense insurance.

COVID-19 vaccine and booster

For COVID-19, vaccines and boosters are also effective tools to help protect you from getting seriously ill. Staying up to date with the latest vaccines and boosters is the best way to protect yourself against new strains of COVID-19. Even people who have had the virus before can benefit from getting vaccinated.

COVID-19 vaccines and boosters are available at no cost to you no matter where you get them. You may be asked to provide insurance information, but you will not be charged. Even those without insurance can still receive a COVID-19 vaccine at no cost.

Get the most from your health plan with routine appointments

It’s important to see your dentist regularly. Dental checkups are the best way to keep your teeth healthy. The American Dental Association says to visit your dentist every six months. Both of those visits are covered by MassHealth each year at no cost to you.

In addition to the two exams and cleanings, your WellSense MassHealth plan provides dental coverage for:

  • Preventive services
  • Flouride treatments for members of all ages
  • Dental sealants for members younger than 21
  • Pain releif and treatment of infections
  • Fillings and crowns
  • Root canal treatment

To find a participating dentist in the MassHealth network and schedule your exam, visit masshealth-dental.net or call 800-207-5019.

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  • Preventive services
  • Fluoride treatments for members of all ages
  •  Dental sealants for members younger than 21
  • Pain relief and treatment of infections 
  • Fillings and crowns
  • Root canal treatment
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Regular eye exams are also important. They can help find eye diseases  early and preserve your vision. Eye diseases are common, but they can go unnoticed for a long time. WellSense members under 21 are covered by MassHealth for an eye exam and new glasses every year, and members 21 and older receive these benefits every two years.

To find an eye care provider, visit our provider directory or call Member Services at 888-566-0010.

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Take the first steps toward a  nicotine-free life

Quitting smoking has health benefits for you and your loved ones. Just 24 hours after quitting, nicotine levels in the blood drop to zero. One to two years after quitting, the risk of a heart attack drops sharply. Even people who have smoked for many years or have smoked heavily will benefit from quitting.

If you’re thinking about quitting smoking, vaping or using other tobacco or nicotine products, visit mass.gov or call 800-QUIT-NOW for additional support. Even if you’ve tried before, keep trying and don’t give up.

Why quit smoking? Doing so will:
  •  Improve your overall health status and enhance your quality of life
  • Add as much as 10 years to life expectancy
  • Keep those around you healthier by eliminating second-hand smoke
  • Improve pregnancy outcomes for both mothers and babies
  • Save money
  • Reduce the risks of many negative health effects, including reproductive health issues, heart disease, chronic lung diseases and cancer
  • Help people with heart or chronic lung diseases stay healthier

What you can do about fraud, waste and abuse

When it comes to healthcare, we all like to think that everyone is doing their best to do the right thing. After all, people need to trust their care providers to look out for their health. That’s why WellSense wants you to know how you can help us keep everyone involved in your healthcare honest by reporting fraud, waste or abuse whenever you experience it.

In a healthcare setting, fraud is a kind of stealing where people lie about things for financial gain, like if you or WellSense ever get charged for services you never received. Waste is when medical services are deliberately overused, like if you are scheduled for extra appointments that aren’t needed. Abuse is when, typically by accident, someone causes services to be paid for that are not needed or not correct.

How to report suspected cases of fraud, waste or abuse

Reporting fraud, waste and abuse to WellSense can help us make sure all our members receive the right care at an affordable cost. If you suspect fraud, waste or abuse, please report it immediately to our confidential compliance hotline at 888-411-4959. Calls to this number are toll-free, and the hotline is available 24 hours a day, 365 days a year.