Massachusetts Marketplace Health Insurance Plans
Qualified Plans on Massachusetts HealthConnector
Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.
You should also look at a Massachusetts HealthConnector plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Massachusetts HealthConnector plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"
Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.
Blue Cross and Blue Shield of Massachusetts. The company is an independent licensee of the Blue Cross and Blue Shield Association, the oldest U.S. health insurance system. The Blue Cross and Blue Shield Association offers coverage in all 50 states, the District of Columbia and Puerto Rico and has 37 Blue Cross and Blue Shield companies that serve over 100 million members (one third of all Americans), according to the company. Nationally, Blue Cross and Blue Shield companies have contracts with over 96 percent of hospitals and 91 percent of providers. Massachusetts residents who buy a Blue Cross and Blue Shield exchange plan may not have access to the entire network of doctors and hospitals.
Boston Medical Center HealthNet Plan. This managed care organization has approximately 280,000 members in Massachusetts, according to the company. BMC HealthNet offers seven exchange plans, ranging from Bronze to Platinum. A service area map and provider listing for BMC HealthNet’s Silver exchange plans as well as a service area map and provider listing for BMC HealthNet’s Bronze, Gold, and Platinum exchange plans are available.
CeltiCare. Established in 2009, this managed care organization is part of the Celtic Group and a subsidiary of the Centene Corporation. Its network includes over 10,000 physicians.
Fallon Community Health Plan. Established in 1977, this nonprofit health services organization offers health insurance coverage for all populations of Massachusetts residents. In September 2013, FCHP’s Medicaid health plan was ranked the highest of any Medicaid health plan in America by the National Committee for Quality Assurance, according to a company press release. Fallon Community Health’s website hosts a searchable directory of physicians, dentists and other health care providers as well as an online drug formulary search tool.
Harvard Pilgrim Health Care. Established in 1980, the nonprofit describes itself as a “full-service health benefits company” that offers health coverage options to over 1 million members living in Massachusetts, New Hampshire and Maine. Its network includes 135 hospitals and 28,000 doctors.
Health New England. As a subsidiary of Baystate Health, this for-profit health maintenance organization (HMO) serves over 122, 200 western Massachusetts residents living in Franklin, Berkshire, Hampden and Hampshire counties as well as part of Worchester county. HNE also serves New York and Connecticut residents who are employed in Massachusetts. Its network includes 4,310 physicians and 14 hospitals.
Neighborhood Health Plan. Established in 1986, NHP is a nonprofit health maintenance organization (HMO) providing comprehensive health services to Massachusetts residents. NHP is a member of Partners HealthCare and its network encompasses Partners’ major academic medical centers – including Massachusetts General Hospital, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, Children’s Hospital Boston, Dana-Farber Cancer Institution and Tufts Medical Center – in addition to major medical groups such as Atrius Health/Harvard Vanguard and Lahey Clinic. Its network includes 4,100 primary care doctors, 13,400 specialists and 68 hospitals.
Network Health. Established in 1997, the nonprofit became a subsidiary of Tufts Health Plan in 2011 and provides health care coverage to over 215,000 residents throughout Massachusetts.
Minuteman. The new, member-governed, nonprofit serves Massachusetts residents in the following counties: Bristol, Plymouth, Norfolk, Middlesex, Worchester and Essex. Its network of more than 4,000 health care professionals and 25 hospitals includes major academic medical institutions and medical groups such as the Tufts Medical Center and the Lahey Clinic. Minuteman’s website hosts a complete list of in-network hospitals and searchable directory of physician practices and pharmacies.
Tufts Health Plan. Established in 1979, this nonprofit offers HMO, PPO and PoS plans and has over 1 million members in Massachusetts and Rhode Island. In 2011, Tufts Health Plan acquired Network Health, a Medicaid plan, making the combined entity one of few Massachusetts insurers to offer Medicare and Medicaid coverage, according to the company. Its network includes over 25,000 physicians and 90 hospitals.
Last updated by Heilbrunn, Evi | December 5, 2013