Is enrollment in a MassHealth managed care plan mandatory?

Whether enrollment in a MassHealth managed care plan is required depends on the member’s eligibility category, age, other insurance, and program participation.

Many managed-care-eligible MassHealth members are required to choose a health plan, such as an Accountable Care Organization (ACO), Managed Care Organization (MCO), or Primary Care Clinician (PCC) Plan. If a member does not make a selection, MassHealth may assign a plan.

Other members, including many individuals age 65 or older and certain long-term-care populations, may receive MassHealth on a fee-for-service basis and are not required to enroll in an MCO.

Because the rules vary by member, families should review the specific MassHealth enrollment options available to them before changing plans.