Boston, affectionately known as “Bean Town,” has a mix of history and modern urbanization that appeals to a wide variety of people. Folks who live in this city work hard and play hard, and all have unique needs and risks. One need most every Boston resident has is for affordable and quality health care.
A Boston, MA health insurance plan can provide financial protection should you become ill or injured. You can locate a health care plan by contacting an independent member agent in the Trusted Choice® network. An independent agent can show you Boston medical insurance quotes so you can choose a health insurance plan that is right for your needs. Contact an agent today to get started.
2010 Adult Health Survey - Boston, MA
- 16% were cigarette smokers
- 11% had asthma
- 6% had diabetes
How Health Insurance Works
In the state of Massachusetts, health insurance is mandatory for any person 18 years of age or older under the “individual mandate.” A Boston health insurance plan must consist of a certain number of basic health benefits, also called “minimum creditable coverage.”
“Minimum creditable coverage” must contain the following minimum healthcare standards, outlined below:
- Prescription drug coverage
- Regular visits to the doctor and for check-ups before any deductible
- Annual deductibles capped at $2,000 per individual and $4,000 per family
- Your plan must limit your out-of-pocket healthcare expenses at $5,000 per individual person and $10,000 per family each year if you have a deductible or co-insurance for core services
- There must be no limit on total sickness benefits each year
- The plan must not limit the amount spent for a one day hospital stay
Where Do I Find a Health Insurance Plan?
There are several approaches you can take to find the type of health insurance plan that suits you best.
You may be able to access a plan offered by your employer or union. You can also purchase a health care plan by using “The Connector." The Connector is a state agency that offers health insurance plans to individuals and small businesses.
If you are an individual in the low-income bracket, you might qualify for a health plan with the state. If your combined family income is less than 300% of the federal poverty level, you might also qualify for a "Commonwealth Care" plan. Financial assistance is made available through the state for Commonwealth Care premiums.
If you do not qualify for subsidized coverage and are between 19 and 26 years of age, you may qualify for a “Young Adult Benefit Plan” through the Connector. Talk to your agent for clarification on the Massachusetts healthcare laws, especially if you think you might qualify for coverage you're not currently receiving.
Types of Conventional Health Coverage Plans
There are several different types of conventional health plans offered through private insurance companies. The range of plans includes the following:
These are frequently referred to as "open network plans." This format applies to several types of plans that will encompass expenses for hospital stays and medical costs. Some plans may or may not also include preventative care. You have the option of choosing any health provider.
Most of these plans cover a percentage of the costs only. For example, if your plan provides coverage for 80 percent of your hospital or medical costs, you would have to pay for the remaining 20 percent out of pocket.
HMO (Health Maintenance Organizations)
These are known as closed network plans and include expense coverage for medical, hospital and preventative health care. You will have to obtain your medical care through providers in your HMO's network. The only exception for this will be in an emergency situation.
Most HMOs will require that you pay a “flat fee” co-payment for any services covered under the plan. Also, you may be required to pay a deductible, and some plans may include coinsurance and benefit limits.
PPO (Preferred Provider Plans)
These plans will provide different benefit levels from the preferred providers and will also include coverage for medical, hospital and preventative care. A PPO utilizes a network of preferred providers and allows for medical services from out-of-network providers. However, the benefits from preferred providers are generally more inclusive than for out-of network providers.
Where Can I Find a Health Care Plan?
Since there is such a range of available Boston health insurance plans, it might be hard to find the coverage you need at a price that makes sense for your budget. An independent agent in the Trusted Choice network can help you navigate the insurance market and compare Boston medical insurance quotes so you can get great coverage with ease.
When you need to save time and money, the right insurance agent can make a huge difference. Because Trusted Choice member agents can access multiple insurance companies, you'll get to see your options and make an informed choice. Contact a local Trusted Choice network agent right now to get the Boston health insurance you need.