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MassHealth waives 30-day supply limits for prescription drugs

The state Medicaid organization will allow 90-day supplies and early refills in response to the coronavirus.


The state’s Medicaid organization Friday said it will allow pharmacies to dispense up to a 90-day supply of most prescription drugs for the low-income residents it serves, waiving a 30-day supply limit in response to the spreading coronavirus that has left many residents homebound.

MassHealth ― which insures about 1.8 million Massachusetts residents, including about 312,000 seniors and people with disabilities ― also said it will permit them to order early refills of their prescriptions to ensure residents have adequate supplies of medicine during the public health crisis.

The changes on prescription coverage will take effect Saturday.

“These policy changes are intended to allow greater flexibility in providing care to MassHealth members who may be affected by the outbreak,” the agency said Friday.

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The changes, which are meant in part to help an older population deemed at higher risk for coronavirus, were part of a series of guidance statements and bulletins issued by MassHealth as state health officials stepped up efforts to address the pandemic affecting nations globally.

Low-income seniors served by MassHealth are known as “dual eligibles” because they are also insured by Medicare, the federal health insurance program for older Americans. Federal health authorities have recommended that older adults avoid large crowds and stay close to home to prevent contracting Covid-19, the disease caused by coronavirus.

In its guidance to health care providers, MassHealth said it would extend telemedicine coverage to all necessary and appropriate care for residents who need remote access to health care as the virus spreads. The agency previously only covered provider visits by phone or computer for behavioral health issues, such as mental illness or substance abuse.

The agency also said it will require senior care organizations and other private contractors that insure low-income residents through MassHealth to follow the same rules ― including no co-pays ― that the organization uses for its own members in covering testing, treatment, and prevention of Covid-19. The rules will also apply to any home visits by providers.

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In addition, as a stopgap measure, MassHealth will expand insurance eligibility for uninsured residents who turn up at hospitals with an illness. Some insured patients were not previously eligible, including former MassHealth members who are no longer enrolled.

A spokeswoman said it hasn’t yet been determined how long the new MassHealth guidance will remain in effect.









Robert Weisman can be reached at robert.weisman@globe.com. Follow him on Twitter @GlobeRobW.