Our Patient Benefits Managers can enroll you in financial assistance programs for which you may be entitled.

We recognize the profound disruptions that serious illness can bring to individuals and families. We refer patients to community-based social services, as well as other professionals who can provide counseling and support to patients and families.

If you have insurance...

• Verify that your insurance company will pay OCHS for claims filed by OCHS.


• Provide OCHS billing office with complete insurance information and claims billing address. Outer Cape Health will file claims whenever possible to any commercial insurance company for patients with HIV.


• Verify that OCHS providers are members of your HMO or PPO Network.


• If OCHS is not your PCP, contact your Primary Care Provider and obtain authorization for the necessary visits to Outer Cape Health.

If you do not have insurance...

• HDAP (HIV Drug Assistance Program)
  
  Enroll through HIV Case Manager at OCHS or your ASO No Income or Qualified Immigration Status requirements.

If you do not have insurance, and you are under the age of 65...

• Family Annual Income less than $17,700 for Single Person and a Year-Round Resident of Massachusetts
  (Contact the Patient Benefits Manager for income levels for larger families)


• Enroll through HIV Case Manager at OCHS or your ASO No Income or Qualified Immigration Status requirements.


• MassHealth Family Assistance




• Allows you to enroll in MassHealth's Primary Care Clinician Plan.


• May pay part of your health insurance premiums if you have or can get group health insurance from your employer or other source; and


• Provides certain medical not covered by your health insurance;


• Covered Services:




• Inpatient hospital services


• Outpatient services: Hospitals, clinics, doctors, dentists, family planning and home-health care.


• Medical Services: Lab, x-rays, therapies, pharmacy, dental, eyeglasses, hearing aids, and medical equipment and supplies.


• Mental health and substance abuse services: Inpatient and outpatient.


• Well-child screenings: Including medical, vision, dental and hearing tests, as well as shots and prescription and non-prescription services.


• Emergency ambulance services.


• Apply with OCHS Patient Benefits Manager or your local ASO.






• Family Annual Income between $17,700 and $45,000 for Single Person and a Year-Round Resident of Massachusetts, regardless of immigration status
  (Contact the Patient Benefits Manager for income levels for larger families)


• CHII (Comprehensive Health Insurance Initiative)




• Program Managed by HDAP.


• Enrollment and Approval by HDAP a prerequisite.


• Full Insurance through a regional HMO with HDAP paying the premiums.


• Pre-existing condition clause for first 6 months.
  (ACT NOW would provide coverage for the first 6 months)




• ACT NOW




• Limited to Primary Care Patients of OCHS.


• No residency, Immigration or Income Guidelines.


• Covered Services:




• Outpatient services by OCHS providers.


• Lab tests billed through OCHS.






• FREE CARE




• Income less than $17,720.00.


• Massachusetts Resident but ineligible for MassHealth due to immigration status.


• Supplements ACT NOW limited funding.