Orlando Harmon
If you are a resident of Massachusetts, you can enroll in a health plan during the annual open enrollment period. You can also enroll at other times of the year if you have special circumstances, such as recently moving to the state or losing your previous health insurance. Massachusetts residents can buy health plans directly from an insurance company, and the company cannot turn you down if you have a pre-existing health condition. You can also apply for MassHealth, a Medicaid program paid for by state and federal taxes for eligible persons. To apply for MassHealth, you can fill out the Massachusetts Application for Health and Dental Coverage and Help Paying Costs, and submit it online, by mail, or in person at a Massachusetts Health Connector Walk-In Center.
| Characteristics | Values |
|---|---|
| Website | www.MAhealthconnector.org |
| Phone | (800) 841-2900 |
| TDD/TTY | 711 |
| Fax | (617) 988-8903 |
| Enrollment Centers | Boston, Brockton, Springfield |
| Enrollment Center Hours | Monday-Friday, 8 a.m.-6 p.m. (Boston); 9 a.m.-5 p.m. (Brockton and Springfield) |
| Health Insurance Plan Types | Comprehensive, HMO, Preferred Provider |
| Health Insurance Plan Providers | Blue Cross Blue Shield of Massachusetts |
| Health Insurance Plan Features | Nationwide network of providers, co-payments, deductibles, out-of-pocket maximums, prescription savings, discounts, benefits |
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What You'll Learn
Eligibility criteria for MassHealth
To be eligible for MassHealth, you must be a resident of Massachusetts and either intend to reside in Massachusetts, with or without a fixed address, or have entered Massachusetts with a job commitment or seeking employment.
MassHealth offers different types of coverage based on your situation. For instance, if you are a parent or adult caretaker relative living with children younger than 19 years of age, or a spouse or former spouse of one of those relatives, and you are the primary caretaker of these children when neither parent is living in the home, you may be eligible for MassHealth.
Additionally, MassHealth has specific eligibility criteria for individuals who are 65 years of age or older, as well as those who require long-term care at any age. To determine eligibility for these individuals, MassHealth considers factors such as the minimum monthly maintenance needs allowance (MMMNA) and the personal needs allowance for those in long-term care facilities.
Financial eligibility is also a critical factor in qualifying for MassHealth. To determine financial eligibility, MassHealth will consider factors such as income, employment, and current health insurance coverage. Massachusetts residents can also purchase health plans directly from an insurance company, and the company cannot turn them down based on health conditions.
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Online application process
The online application process for medical insurance in Massachusetts involves several steps and requirements. Firstly, you need to determine your eligibility for MassHealth, the state-specific health insurance program. MassHealth offers coverage for individuals and families who meet certain income requirements and provides benefits such as doctor visits, dental, prescription drugs, and behavioural health services.
To initiate the application process, create an MA Login account on the official Massachusetts government website, mass.gov. This secure account will allow you to share sensitive information and apply for MassHealth. You may be asked to provide Social Security numbers for each household member who is applying for coverage. Additionally, MassHealth offers assistance through its Customer Service Center, which can be reached by calling (800) 841-2900. Interpreter services are available, and self-service options are accessible 24 hours a day in English and Spanish.
For those who prefer an in-person application process, Massachusetts Health Connector Walk-In Centres offer free help with applying for coverage, choosing a plan, and understanding eligibility, payments, and health care reform rules. These centres are located in Boston, Brockton, and Springfield, and their operating hours vary. Alternatively, you can call the Health Connector Customer Service Call Center at (877) 623-6765.
If you are specifically interested in Blue Cross Blue Shield of Massachusetts, you can reach out to Team Blue at 1-800-422-3545 to learn more about their plans and sign up.
Remember, it is important to carefully review the different types of health plans available and choose the one that best fits your needs and circumstances.
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In-person application process
If you are applying for MassHealth, the Health Safety Net, or the Children's Medical Security Plan, you can visit one of the Massachusetts Health Connector Walk-In Centers for in-person help. The Massachusetts Health Connector has trained and certified individuals to help you apply for coverage, shop for plans, answer your questions about your eligibility, payments, plan details, and health care reform rules and requirements. Help is free for people of any income level.
Please note that Massachusetts Health Connector Walk-in Centers cannot process applications for people 65 or older, or for people who need long-term care. The following are the addresses of the Walk-In Centers:
- Boston: 133 Portland Street Boston, MA 02114. Hours: Monday - Friday: 8:00 a.m. to 6:00 p.m.
- Brockton: 63 Main Street Brockton, MA 02301. Hours: Monday - Friday: 9:00 a.m. to 5:00 p.m.
- Springfield: 88 Industry Avenue, Suite D Springfield, MA 01104. Hours: Monday - Friday: 9:00 a.m.
You can also visit an Enrollment Center for limited walk-in appointments. The Enrollment Centers have after-hours drop boxes available to submit your application in person. The address for the Enrollment Center is:
Chelsea (new location): 45 Spruce Street Chelsea, MA 02150
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Choosing the right health plan
Massachusetts offers its residents a variety of health insurance plans, with different cost-sharing features and ways to buy a health plan. Residents can buy health plans directly from an insurance company, and the company cannot turn them down if they have a pre-existing health condition.
MassHealth
If you meet certain income requirements, you may be eligible for MassHealth, a Medicaid program paid for by state and federal taxes. You can apply online by creating an MA Login account or by filling out and signing the Massachusetts Application for Health and Dental Coverage and Help Paying Costs (ACA-3). You can also visit one of the Massachusetts Health Connector Walk-In Centers for free help in person.
HMO plans
HMO plans cover hospital, medical, and preventive care. You are only covered if you get your care from an HMO's network of providers (except in a case of emergency). With most HMO plans, you pay a copayment for each covered service. For example, you pay $30 for an office visit and the HMO pays the rest. HMO Blue Essential is a good option for students or those who don't have an employer plan yet.
Preferred provider plans (PPP)
PPP usually covers hospital, medical, and preventive care. These plans have a network of preferred providers that you can use, but they also covers services for out-of-network providers. PPPs will pay more of the cost if you use an in-network provider. For example, after copays and deductibles, the plan pays 100% of a service for a network provider but 80% for an out-of-network provider.
Discount plans
Discount plans are not a substitute for health insurance. They charge a monthly fee in exchange for access to healthcare services at a reduced fee. These plans do not meet your Massachusetts "individual mandate" requirement for health coverage.
Health care sharing ministry plans
These plans allow groups of people with a religious affiliation to share in the costs of certain specified healthcare costs.
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Health insurance basics
Massachusetts residents can buy health plans directly from an insurance company, and the company cannot turn you down if you have a pre-existing health condition. If you meet certain income requirements, you may be eligible for MassHealth, a Medicaid program paid for by state and federal taxes. You can also apply for MassHealth online by creating an MA Login account.
There are many different types of health plans available in Massachusetts, so it's important to choose the one that fits your needs. Comprehensive health insurance provides benefits for a broad range of health care services, including hospital, medical, and preventive care. These plans typically require co-payments and deductibles. HMO plans are also available, which cover hospital, medical, and preventive care. With most HMO plans, you pay a copayment for each covered service. For example, you might pay $30 for an office visit.
Massachusetts residents can also buy health plans through their school if they are enrolled as students at a college or university in the state. Massachusetts has its own individual mandate, and residents who don't have health insurance are subject to a penalty when they file their state tax returns. The open enrollment period for individual/family health coverage in Massachusetts runs from November 1 to January 23.
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Frequently asked questions
Massachusetts residents can buy health plans directly from an insurance company. You can also apply for MassHealth, the state's Medicaid program. You can apply online by creating an MA Login account or by filling out and signing the Massachusetts Application for Health and Dental Coverage and mailing it in.
There are many different types of health plans offered in Massachusetts. HMO plans cover hospital, medical, and preventive care, but you are only covered if you get your care from HMO's network of providers (except in an emergency). Preferred provider plans also cover hospital, medical, and preventive care.
It's important to look for a plan that fits your needs. Comprehensive health insurance provides benefits for a broad range of health care services and may limit your costs if you use in-network providers. You can also use the MyBlue app from Blue Cross Blue Shield of Massachusetts to find doctors in your network and view your medication history and health plan ID card.
Yes, you can visit one of the Massachusetts Health Connector Walk-In Centers for free help in person. The Massachusetts Health Connector has trained and certified individuals to help you apply for coverage, shop for plans, and answer your questions about eligibility, payments, and plan details.
Yes, you may be able to enroll outside of the annual open enrollment period if you have special circumstances, such as recently moving to Massachusetts or losing your health insurance.
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