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Member Newsletter

WellSense Essential MCO

Stay on the path to healthy: It's time to renew your MassHealth benefits

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MassHealth members need to renew their coverage each year to keep their health insurance.

During the COVID-19 pandemic, MassHealth put protections in place that kept coverage from ending. However, these have ended, and MassHealth has started the renewal process. Even if you are new to WellSense this year, you may need to renew with MassHealth. This means you should:

  • Update your contact and household info with MassHealth
  • Watch your mail for a blue envelope from MassHealth
  • Act on any notices you receive about this

If MassHealth has enough information about you, they will renew your coverage automatically. If not, they will send a renewal form in a blue envelope to the mailing address they have on file.

Avoid the wait: Getting care faster than at the ER

Injuries and illnesses can happen at any time. While a walk-in visit to the emergency room (ER) may often feel like the easiest solution, ERs often take much longer to treat conditions that could be handled more quickly for you somewhere else. 

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Your PCP
For most nonemergency conditions, your primary care provider (PCP) should be your first resource. Your PCP is the provider you generally see for your annual wellness visit. They know your health the best and can help you get specialist care quickly if you need it. If your PCP isn’t available, you can also try to see another provider in their office or schedule a telehealth visit, which will often be faster. 
Urgent Care
If no one at your PCP’s office is available to see you quickly, an urgent care clinic should be able to make an appointment for you within 24 hours, and walk-in urgent care wait times are usually shorter than at the ER. If your PCP belongs to a larger healthcare system, you may even be able to go to an affiliated urgent care clinic. Urgent cares can handle most nonemergency illnesses and injuries. 
Emergency Room
If you are experiencing a medical emergency, you should always call 911 or go to the nearest emergency room.
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Call our 24/7 nurse advice line for questions about non-emergency health concerns or where to find after-hours care at 800-973-6273.

Don't get scammed

Are you being asked to pay for healthcare that is actually covered by your insurance? Has someone called you asking you to pay for services like changing your insurance or updating your address? These may be scams. Call 888-411-4959 to report them, and visit wellsense.org/footer/fraud-waste-and-abuse for more information.

Get help finding food 

You can call 211 to learn what help is available for food and other needs.

If you or your family isn’t getting enough healthy food, you are not alone. According to Feeding America, more than 34 million people in the United States don’t, and more than 53 million used food programs to help them in 2021. If you need help with getting more healthy food, the resources below may help.

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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
Project Bread
Project Bread can walk you through the benefits you or other members of your family qualify for and tell you where to find your local food bank. You can reach them at 800-645-8333.
BMC food pantry
If you’re a patient at Boston Medical Center, you can ask your healthcare provider about their food pantry.
SNAP benefits
If you receive SNAP benefits and are now paying more for medical care, housing or caring for another person, you may be eligible for an increase in your benefit.
Massachusetts Healthy Incentives Program

Massachusetts Healthy Incentives Program automatically puts money back on your SNAP/EBT card when you use it to buy healthy fruits and vegetables from participating vendors.

Free cookbook download
“Good and Cheap” is a free-to-download cookbook focused on eating yummy, healthy food on just a few dollars a day.
The BMC Teaching Kitchen
The BMC Teaching Kitchen also offers free, monthly, online cooking classes featuring healthy, easy-to-cook and budget-friendly meals.

Get to know your behavioral health benefits

WellSense is dedicated to helping our members live their best lives, and that includes supporting you with any behavioral health (BH) needs. Your BH coverage includes mental health (like grief counselling and therapy to help with stress), substance use and addiction services.

WellSense provides BH services through Carelon Behavioral Health. Carelon has providers conveniently located throughout Massachusetts and the rest of the US. Most BH services are available automatically through self-referral. This means you do not have to get prior approval to visit a BH provider in Carelon’s network.

If you or a family member are experiencing a mental health or substance use crisis, the Massachusetts Behavioral Health Help Line is available 24 hours a day, 7 days a week, 365 days a year. Anyone can contact the Help Line. Call toll-free or text 833-773-2445 (TTY: 711) for immediate help

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To find a behavioral health provider:
  1. Visit carelonbehavioralhealth.com
  2. Click on “Find a Provider” at the top of the page
  3. Type your WellSense Health Plan’s 
    name in the box shown
  4. Search for a specific provider, or 
    enter your ZIP code to find one 
    near you

    Or call Carelon at 888-217-3501 (TTY: 711) for help finding a provider or to ask any questions about your BH benefits

Is care management right for you?

WellSense offers our free Care Management Program to help members with conditions like asthma, diabetes or other special health needs. Qualifying members receive personalized care management from a nurse or social worker. The care manager can help manage your healthcare needs with special attention to your condition(s). This includes:

  • Helping you understand and manage your specific disease(s) or condition(s)
  • Helping you access essential services, including housing, food and transportation
  • Having regular check-ins over the phone regarding your health and your needs
  • Coordinating your care with your doctors, other healthcare providers and community partners
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Check if you qualify

You may qualify for care management based on the results of a short care needs screening. You can complete the screening online in our member portal. First time users will need their ID number from their WellSense ID card to create an account by clicking on “Member Registration."