Massachusetts Health InsuranceIndividuals and Families

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Massachusetts Health Insurance
How to find an affordable plan.

With fewer companies offering employer sponsored health insurance and people finding themselves without jobs, the challenge of choosing a health care plan has left many individuals confused and afraid. For residents of Massachusetts, enrolling in health insurance no longer has to create anxiety and hardship as there are many resources available to simplify their search. Health Insurance Online is one option consumers can utilize to request several different quotes and research the various providers in the state of Massachusetts. Before making a decision on health insurance it is important to compare and contrast the different plans offered, review coverage options for both individuals and families, and the cost of each plan.

Leading Massachusetts Health Insurance Companies

Aetna of Massachusetts: Aetna Health Insurance offers the people of Massachusetts many wonderful health insurance choices that are affordable.

Blue Cross and Blue Shield of Massachusetts: Blue Cross and Blue Shield has been providing affordable health insurance coverage to residents of Massachusetts for several years.

Harvard Pilgrim Health Care of Massachusetts: For over thirty-five years, Harvard Pilgrim has built a reputation for exceptional clinical quality, preventive care, disease management and member satisfaction and has consistently rated among the top plans in Massachusetts.

HumanaOne of Massachusetts: HumanaOne offers affordable health insurance coverage for individuals and families in Massachusetts, which include self-employed entrepreneurs, students, recent college graduates and those people who may be uninsured.

Kaiser Permanente of Massachusetts: Kaiser Permanente Insurance Company has revitalized its Northeastern United States divisions and is once again available to the residents of Massachusetts.

Health Insurance in Massachusetts

The state of Massachusetts has a law in place called the "individual mandate" that require all individuals age 18 or older to have health insurance. In order to meet the rules of the law, plans that are sold in Massachusetts must meet the "minimum creditable coverage" standards:

  • Covers prescription drugs (may have deductible of up to $250 per individual/$500 per family
  • Covers regular doctor visits and check-ups before any deductible
  • Caps the annual deductible at $2,000 for an individual or $4,000 for a family
  • If you have a deductible or co-insurance on core services, caps out-of-pocket spending for health services at $5,000 for an individual or $10,000 for a family each year
  • Does not cap total benefits for a sickness or for each year; and,
  • Does not cap spending for a day in the hospital.

In order to meet the individual mandate and protect yourself from high healthcare costs it is important to join a health plan. For those that are employed within the state of Massachusetts it would be best to first check if employment-based coverage is available. Many employers pay a portion of the premium and may offer additional options that may not be available if you were enrolling on your own. For those that would like to buy a health plan directly from an insurance company there is the option to buy individual and family plans. These plans vary depending on the amount of coverage options that you require. Individuals enrolled as a student in a Massachusetts college or university can buy a special health plan directly from their school. This program is called the Qualified Student Health Insurance Plan (QSHIP) and is designed and only available to students. For those that may need financial assistance in order to purchase a health care plan the state has created the MassHealth program. Individuals can find more information about this program at http://www.mass.gov/eohhs/gov/departments/masshealth/ .

Finding Massachusetts Health Insurance

With so many health care choices available to consumers in Massachusetts it is important to do proper research to identify what plan covers all of your family's needs. The best place to start your search is online. Using the Internet, an individual can receive several different price quotes and thoroughly examine the different providers. By taking a look at the individual provider's websites you will be able to get a broad look at what they offer and helpful information to make the best decision for you and your family. If you are employed, check with your human resources department to see if there is an employer sponsored health plan.

Being without a job, or working without benefits is stressful. Illness or injury can occur at any time so it is important to make sure you have a plan that is affordable and that can protect your loved ones in a time of crisis.

Types of Massachusetts Health Plans

There are many types of health plans available in the state of Massachusetts. Each plan has its own set of policies and coverage restrictions. When selecting a health care plan it is important to not only pick a plan that is affordable but also one that meets your needs.

The most popular types of health insurance plans are Health Maintenance Organization Plans (HMO), Preferred Provider Organization Plans (PPO), and Point of Service Plans (POS). HMO plans are the most popular type of health insurance plans available. The combination of low premium cost and low co-pay cost make them very attractive to individuals and families. HMO plans require individuals to choose a primary care physician (PCP) within their health network and must go through their PCP before seeing a specialist. Generally, you will pay less out-of-pocket costs but will have limited options for out of network care than with a PPO plan. PPO plans offer a bit more freedom compared to HMO plans in that individuals are not required to see their primary care physician before seeing a specialist. PPO plans tend to have largest networks and it may be easier to get care outside of your health network. A Point of Service insurance plan (POS) gives you a limited amount of choice in terms of doctors and specialists in return for lower priced premiums and co-pays. When you're in a POS plan, you choose only your primary care physician from within the health insurance company's network, and if you need to see a specialist outside of the network, the company might only offer some financial coverage.

Resources and Information

Massachusetts Medicare Plans

Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio.  Medicare plan options include Medigap and Medicare Advantage policies:

Massachusetts Doctor Directory

Doctors practicing medicine in the State of Massachusetts are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.

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