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Massachusetts Health Insurance

massachusetts state flag

Prior to the Affordable Care Act, Massachusetts enacted fairly comprehensive health reform by 2006 under its former governor, Mitt Romney. According to a Kaiser Family Foundation profile of the state from September 2013, Massachusetts’ health reform became the model for national health reform.

Later, the Massachusetts Health Connector became certified as a state-based health insurance marketplace under the Affordable Care Act. Additionally, Massachusetts is one of 27 states including Washington, D.C., to expand Medicaid coverage in 2014. 

If you are interested in learning more about Massachusetts health insurance alternatives, you can visit the state marketplace at MaHealthConnector.org. From here, you can apply for a private marketplace plan during open enrollment and learn if you qualify for a subsidy.

If eligible, you may also be directed to apply for Medicaid or the Children’s Health Insurance Program for government-sponsored aid. 

Do you qualify for a Massachusetts health insurance subsidy?

According to a Kaiser Family Foundation profile of the uninsured in Massachusetts, 57 percent of the previously uninsured in Massachusetts should be eligible for some type of financial assistance because of the Affordable Care Act.

About 20 percent of previously uninsured residents may qualify for tax credits to help offset the costs of plans purchased on the marketplace, and another 36 percent might be eligible for Medicaid or CHIP. 

Here’s what you should know about financial assistance surrounding health insurance in Massachusetts.

  • Eligibility for subsidies will typically be based on 2013 poverty level limits, and Medicare and CHIP qualification will typically be based on 2014 limits. 
  • People with income between 100 and 400 percent of the poverty level may qualify for a subsidy. This would be between $23,550 and $94,200 for a family of four and $11,490 and $45,960 for an individual.
  • Massachusetts adults with income less than 138 percent of the poverty level and kids with a family income of less than 305 percent of the poverty level may qualify for Medicaid or CHIP.

What if you earn too much money to qualify for assistance or already have health insurance? You can still purchase marketplace health insurance, or keep your current plan if it stays active and meets certain criteria. 

Health insurers participating in Massachusetts Health Connector

The following are some companies with marketplace health insurance plans.

  • Blue Cross and Blue Shield of Massachusetts
  • Boston Medical Center HealthNet Plan
  • CeltiCare
  • Fallon Community Health Plan
  • Harvard Pilgrim Health Care
  • Health New England
  • Neighborhood Health Plan
  • Network Health
  • Minuteman
  • Tufts Health Plan

Massachusetts health and coverage statistics

Massachusetts population (2013): 6,692,824
Population 65 and older (2012): 14.4 percent
Life expectancy (2010): 80.5 years
Number of Medicaid beneficiaries (2012): 1,420,100
Number of Medicare beneficiaries (2012): 845,000
Estimated number of uninsured residents (2012): 245,800

Overall state health ranking (2014): 4

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.

Massachusetts health insurance resources

Massachusetts Health Connector (Massachusetts’ state marketplace): https://www.mahealthconnector.org/

Massachusetts Department of Health and Human Services: http://www.mass.gov/eohhs/gov/departments/dph/

Massachusetts Division of Insurance: http://www.mass.gov/ocabr/government/oca-agencies/doi-lp/

MassHealth (Medicaid)http://www.mass.gov/eohhs/gov/departments/masshealth/

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