Massachusetts Health Insurance

Information on Massachusetts Health Insurance

Find the right health insurance policy for you.

Your health is important. Health insurance can help you receive medical care at a price that's affordable even though the cost of hospital stays and doctor's visits are rising daily. When you're sick, injured, or needing medical attention, get peace of mind with Massachusetts health insurance.

A Massachusetts health insurance plan can protect you and your family from the high costs of medical treatment. You can find a health care plan by contacting a local independent agent in the Trusted Choice® network. These independent agents can provide Massachusetts medical insurance quotes so you can find a policy that protects your family’s health. Contact an agent today to find the health coverage you need.

Work-Related Injury Statistics

  • There were 70,500 non fatal work-related illnesses and injuries
  • The incidence rate of illness and injuries was 3.1 per 100 full-time workers
  • The wood product manufacturing sector has the highest accident rate at 10.9 incidents per 100 workers

Massachusetts Health Insurance Basics

Under the individual mandate, a Massachusetts health insurance plan is legally required for anyone 18 years of age or older. Your health insurance requirements must contain certain basic benefits known as “minimum creditable coverage.”

“Minimum creditable coverage” is defined as any plan which meets the following minimum standards:

  • Covers prescription drugs
  • Covers regular doctor visits and check-ups
  • Has an annual deductible capped at $2,000 for an individual and $4,000 for a family
  • If you have a deductible or co-insurance for core services, the plan must cap out-of-pocket spending for health services at $5,000 for an individual and $10,000 for a family each year
  • Does not cap total benefits for sickness each year
  • Does not cap spending for a day spent in the hospital

How Do I Find a Health Coverage Program?

You will have to enroll in a health plan to get healthcare coverage. A Massachusetts health insurance plan may be available through your employer or union.

Another option is to buy a plan through “The Connector”. The Connector is a state agency that offers health plans to both individuals and also to small employers.

Low-income individuals who are eligible may be able to get a plan through the state. If your family income is less than 300% of the federal poverty level, you may be able to buy a "Commonwealth Care" plan from the Connector. Massachusetts provides financial assistance to cover Commonwealth Care premiums. This means that you pay a smaller premium or none at all, depending on your income.

If you are between 19 and 26 years of age and are not eligible for subsidized coverage from your job, the Connector offers a Young Adult Benefit Plan for Massachusetts residents.

Your third option is to use an insurance company which sells health plans to individuals. These plans are described in more detail below.

Traditional Health Coverage Plans

Traditional health plans allow you to choose from a variety of health plans through private insurance companies.  Generally, you have the following choices:

Medical /Indemnity Plans (Open Choice or Open Network Plans)

These types of plans will cover both hospital and medical expenses, and may include preventative care. You are generally covered for any health provider you use. A medical/indemnity plan may cover only a specific percentage of the costs of care, however.

Health Maintenance Organizations (Closed Network Plans)

These plans cover medical, hospital and preventative health care. You must receive your care through a network of providers, except in an emergency situation. The majority of HMO plans require a flat dollar copayment for covered services. You may also have to pay a deductible, and some plans have coinsurance and benefit limits.

Preferred Provider Plans (Different Levels of Benefits from Preferred Providers)

These plans will also cover medical, hospital and preventative care coverage. A PPO uses a network of preferred providers but also includes coverage for services from out-of-network providers. The benefits you receive from preferred providers are usually greater than those providers who are out-of-network.

Where Can I Find Health Care In Massachusetts?

There are a variety of Massachusetts health insurance plans offered by a number of insurance companies. The cost of these plans can vary significantly, which is why comparison shopping is so important.  The easiest approach to finding a plan that is right for you is to contact a local independent agent in the Trusted Choice network.

These independent agents can access plans offered by numerous carriers so you can use their services to make an informed choice. Contact an agent today to get the process started.

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