What companies represent Massachusetts health insurance?
Health Connector, an independent Massachusetts state agency organized specifically to help state residents find health insurance coverage and avoid tax penalties. As part of the Massachusetts health care reform act of 2006, the independent Health Collector authority came into being.
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The Health Collector serves as a health insurance broker for a wide variety of insurance programs
What is the Health Connector?
The reform act required most Massachusetts residents to obtain at least minimum basic health insurance coverage on their own, or suffer tax penalties. For those with lower incomes, the law provides assistance for individuals and families at three income levels.
First, the act provides subsidies for qualifying individuals and families at 300% of the federal poverty income standard. Those unable to afford insurance, at 150% of the poverty guidelines, are provided with free coverage. Citizens who meet Medicaid (Mass Health) income guidelines, those at the lowest income levels, are covered through Medicaid.
Has the health care reform program worked?
Yes! According to government statistics, Massachusetts now has the highest percentage of insured persons in the United States, with more than 98% of residents having health coverage.
The law does provide some exceptions and exemptions from obtaining health insurance coverage, but those individuals have been taken into account in these surveys.
Hundreds of thousands of Massachusetts residents have been added to the health insurance rolls with only modest increases of about 1% in the state budget over the last five years.
In the last five years, the Health Connector has assisted more than 200 thousand Massachusetts residents in obtaining health insurance through their Commonwealth Choice or subsidized Commonwealth Care programs.
What options do I have with Commonwealth Choice?
Health Connector reviews all private company plans for their quality and value before stamping them with their seal of approval. Not all plans are available in all areas of the stat. A service or coverage area is not the same as a provider network. Consumers should check into the details of each individual plan for more information.
Commonwealth Choice includes plans with the following vendors:
- Blue Cross and Blue Shield of MA
- BMC Healthnet
- Harvard Pilgrim Health Care
- Fallon Community Health
- Healthy New England
- Tufts Health
- Neighborhood Health
Commonwealth Choice makes shopping easier, providing policy details for all vendors right on line. Once you have made a selection you may also enroll on line or by calling the toll free hotline, 877-623-6765. Health Connector will also mail out company brochures on request.
Employers also have options with Commonwealth Choice. Employers with 50 or fewer employees can offer group plans featuring employer contributions through Commonwealth’s Business Express program. Under the government’s “Section 125 Plan,” employers of any size can offer health plans that allow employees to purchase their own health insurance, using tax-free dollars.
What is Commonwealth Care?
Commonwealth Care is the state sponsored health insurance program for uninsured adults who meet income and certain other eligibility requirements. Qualifying guidelines are subject to change and are published on March 1 of each year.
Those who are eligible, choose their own health plan and personal care physician. Plan benefits include:
- Preventive care
- Regular doctor’s visits
- Treatment for injuries and illness
- Prescription drugs
- Vision services
- Mental health or substance abuse services and treatment
Some members may even be accepted for dental insurance.
How do I sort through the insurance choices on Health Connector?
The Health Connector has a portal designed to help consumers quickly and efficiently sift through all available insurance options. Programs are divided into categories:
- Individuals and families
- Young adults, 18- 26 years of age
- Employees, who can shop for their company sponsored programs using their employee IDs
- Employers, looking for group programs
- Insurance brokers, and other professionals wanting to help employers connect to these state sponsored programs
Once inside the portal, select a category and handy calculators will determine which programs might be best suited to your individual or family needs. As the Health Connector is a non-profit agency, it will also check your eligibility for one of its subsidized programs to make sure that each resident’s resources are put to the best possible use.
Once a final insurance selection is made, all paperwork can be completed on submitted through the very same website. Members also have the advantage of managing their policies and submitting payments through the Health Connector website.
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