Tressa has been disabled since birth due to a condition that affected the calcification of her bones. Using a wheelchair to get around, Tressa has established a professional career in the non-profit sector. Because of her condition, Tressa cannot be without medical coverage.
In October 2010, Tressa received a notice from MassHealth that her medical coverage would be terminating. In desperation, she contacted MWLS. The MWLS paralegal advised Tressa of her rights to appeal the pending termination which would prevent a loss of coverage while the action was being investigated. The paralegal requested a Fair Hearing on Tressa’s behalf.
After meeting with Tressa,the paralegal determined that Tressa’s coverage was being terminated because she hadn’t paid her monthly premium- a premium that was assessed based on Tressa’s full-time wages. Because Tressa had been out of work on medical leave, receiving Short Term Disability since falling out of her wheelchair and sustaining complicated fractures, her reduced income did not allow her to pay premiums. She had received a six-month financial hardship waiver, which had expired, and she had not reapplied for another six-month waiver. The paralegal assisted Tressa with providing MassHealth with updated income documentation. After some resistance, MassHealth updated her coverage to Standard without a premium. This eliminated the need for an additional waiver now that her income was correctly calculated.
The paralegal then successfully advocated for MassHealth to waive the outstanding premium. Once MWLS confirmed Tressa’s coverage was active, the Paralegal withdrew the Fair Hearing request. The case closed in May 2011, and Tressa has had the uninterrupted medical coverage that she desperately needs.