Massachusetts Health Insurance
If you live in Massachusetts and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:
- Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
- Learn about new Obamacare Health Exchange Plans, which could save you money in 2014
- Compare currently available private health plans using U.S. News & World Report's health insurance ratings for Massachusetts
Do I Qualify for a Tax Break on Health Insurance?
Use the calculator below to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.
What Plan Type is Right For Me?
You may qualify for Medicaid, a free, state-sponsored health insurance program. Call 877-623-6765 or go to the Massachusetts HealthConnector website to find out if you can enroll in Medicaid.
You qualify for a subsidy (tax credit) that will save you money if you buy a plan on Massachusetts's new insurance marketplace, called Massachusetts HealthConnector. Plans should be offered there starting October 1, 2013. While your subsidy will cover part of the monthly premium for any of the marketplace's plans, a plan that's in the "silver tier" probably offers the best deal. That's because you also qualify for a second subsidy that increases the value of benefits you'd get from any silver plan.
You qualify for a subsidy (tax credit) that will save you money if you buy a health plan on Massachusetts's new insurance marketplace, called Massachusetts HealthConnector. Plans should be offered there starting October 1, 2013. Your subsidy will cover part of the monthly premium for any of the marketplace's plans, known as Qualified Health Plans.
You don't qualify for a subsidy. You can either buy a plan on the Massachusetts HealthConnector website or click the button below to compare U.S. News-rated plans in your state's private insurance market. Plans on Massachusetts HealthConnector will generally offer more health coverage than plans in the private market, but they also tend to cost more in monthly premiums. The Massachusetts HealthConnector website should offer plans beginning October 1, 2013.
Any children in your household may be eligible for Medicaid. Call 877-623-6765 or go to the Massachusetts HealthConnector website to find out if your children are Medicaid-eligible.
If You Qualify: Plans That Cost Less
Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Massachusetts. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage. The sign-up process started on October 1, 2013 for coverage that commences January 1, 2014 for these plans.
- See a list of Massachusetts’s Obamacare Health Exchange Plans
- For more information, read Why Get Health Insurance in the State Marketplaces
If You Don't Qualify: Private Plans
If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Massachusetts’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage. What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.
Do I Have To Buy Health Insurance?
You may have heard that everyone in Massachusetts must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per person (up to $285 per family) or 1 percent of your family’s income, whichever is more.
U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.
- See the pros and cons of getting health insurance: Why Do You Need Health Insurance?
- For more on the penalty, read Should I Pay the Penalty?
- If your health insurance policy was cancelled earlier this fall, you may be eligible to renew it for 2014 coverage. Call your insurer to verify whether your plan is still available. For more info, read Cancelled Health Plans Leave Consumers Puzzled
Where To Buy Health Insurance
Massachusetts's Official Marketplace
Massachusetts HealthConnector is Massachusetts’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Massachusetts HealthConnector, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:
- Social security numbers for everyone in your household
- Your employer’s name and address
- Your most-recent pay stub or recent records of your wages
- Information about other types of income you receive, such as alimony, unemployment benefits or a pension
Insurance Companies and Brokers
Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Massachusetts HealthConnector website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.
U.S. News & World Report has teamed up with eHealth.com, an online broker licensed to sell health insurance, to help you buy the health plan you want. The eHealth customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.
Need More Help?
If you need help choosing a health insurance plan or filling out your application, Massachusetts has trained nongovernment groups to guide you through the process. Sometimes called “Navigators,” these groups can answer technical questions on insurance, Medicaid, and tax credits (subsidies on monthly premiums) . Navigators also specialize in assisting non-English speaking populations. For more information, contact the Massachusetts Health Connector call center at 877-623-6765. The center is open Monday through Friday from 7:00 a.m. to 7:00 p.m. and on Saturdays from 9:00 a.m. to 3:00 p.m.
The Massachusetts Division of Insurance Consumer Affairs and Business Regulation exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 877-563-4467 or emailed at email@example.com. Residents can file an insurance complaint by mail.
Frequently Asked Questions About Health Insurance
- Why Do You Need Health Insurance?
- Should I Pay the Obamacare Tax Penalty?
- How Can I Save Money on Health Insurance?
- What Should Women Look For When Buying Health Insurance?
- Are 'Affordable' Health Plans Really Affordable?
Last updated by Heilbrunn, Evi | December 6, 2013