Not everyone in Massachusetts has proper coverage, and this is something that we, at HealthQuoteInfo, wish to change. We offer our expertise and guidance to those who need Massachusetts health insurance coverage.
You can buy private insurance for individuals or families from the private marketplace, or you can obtain coverage from your employer. However, those who have low incomes or special needs can qualify for assistance from various federal and state programs. These programs are designed to provide health benefits to those who need it the most.
Medicare, Medicaid & Low Income Health Insurance Massachusetts
Medicare is a federal program that provides health insurance to those over the age of 65. But it also offers assistance for people with disabilities. It offers free or low-cost Part A coverage which includes inpatient hospital care along with some nursing facility services. Part B covers the cost of diagnostic x-rays, laboratory tests, durable medical equipment, and physician care. The Part D program helps with the expense of prescription medicine.
The state administers the Medicaid program, and it offers health insurance assistance for those not covered by Medicare. In general, it helps people with low income who cannot obtain health insurance through the private marketplace or the workplace. However, it also helps some groups of people with special needs.
There is also the federal Children’s Health Insurance program, and each state has its version of it. In Massachusetts, Medicaid and CHIP has been combined into a single program called MassHealth. This offers six types of health insurance coverage for individuals, families, and those with disabilities.
This is the coverage type that offers a full range of healthcare benefits. It comes with stringent requirements including low-income ceilings and proper US citizenship or legal immigrant status.
The benefits include adult day health and adult foster care and well-child screenings for children under 21 along with vision, dental, hearing, and mental health care. Transportation services are covered too.
Under this coverage, disabled adults who also get Medicare Part B can have MassHealth pay for their Medicare premiums, coinsurance, and deductibles.
This also offers behavioral health services for youth under 21 who have significant mental health needs or serious emotional disturbance. The same services are available under the MassHealth Commonwealth plan. The child can be enrolled in the Commonwealth plan if they are ineligible for the Standard plan and they have the mental or emotional issues that need to be treated or managed.
Children in the Standard plan also get Early and Periodic Screening, Diagnosis, and Treatment services (EPSDT). Some services may require copayments, but at least it covers all medically necessary services under the law.
The plan can also accommodate those who are medically disabled. This means you’re limited in your ability to go to work, school or you may have trouble with ordinary tasks such as dressing or bathing.
The healthcare benefits you get from this program are similar to the Standard’s benefits. This coverage is for disabled adults and disabled children who are not eligible for the Standard Coverage. It also covers treatments for mental and emotional issues and EPSDT services for children under 21.
Adults who otherwise cannot qualify for the Standard plan may instead qualify for CarePlus. There may be some limits to the services, but you do get inpatient and outpatient hospital services including dental, vision care, and family planning. Medical services such as lab tests, pharmacy services, and supplies such as hearing aids and eyeglasses can be covered as well.
This also covers services for mental health and addiction, including services to enable you to quit smoking. Home health services and transportation services are also covered.
MassHealth Family Health Insurance Assistance
This is mainly for children in families whose income keeps them from qualifying for the Standard plan. With this plan, the income ceiling is raised to 300% of the federal poverty level to include more enrollees. For a family of four, this income ceiling is $75,300 per year.
MassHealth Premium Assistance
What if you’re already on another type of health insurance, but you’re having trouble paying the premiums? This plan can help pay for part or the entirety of your monthly premiums.
To qualify, you need to maintain any health insurance plan that doesn’t cost anything for you, such as Medicare. MassHealth may also determine that you should enroll in your work-sponsored job insurance if it is available. This may be an option if such a move may be more cost-effective for the MassHealth budget.
If you are living with someone who has employer-sponsored insurance (ESI) and you’re an eligible MassHealth member, then you can qualify for premium assistance. This health insurance option must also meet the requirements at the Basic Benefit Level.
As the name of the plan implies, this program offers coverage for mostly emergency services only. In general, this type of limited coverage is at least available for those with an immigration status that keeps them from getting basic health insurance through other means.
You can always just use our search bar and enter your zip code if you’re looking for private health insurance plans. But for other health insurance concerns, we at HealthQuoteInfo can offer some guidance as well.
Massachusetts Open Enrollment 2019 & Massachusetts Obamacare Insurance
The Massachusetts Open Enrollment period for health insurance in 2019 will run from November 1st, 2018 to December 15th, 2019.
For all your other questions regarding health insurance in Massachusetts, please do not hesitate to give us a call at 1-855-614-5057. We stand ready to guide you so that you can get the health & medical insurance coverage you need and deserve.