Insurance

Best Ways To Get Affordable Health Insurance In Massachusetts

Did you know Massachusetts is the birthplace of basketball and volleyball and is home to the famous Havard university?. There are so many historical landmarks in the Old Bay State that would keep you mesmerized.  It’s a wonderful place to be.

Living with so much vitality and sound health is priceless. Having your health insured is a good and important thing to do and it is a risky gamble being without one.

Health insurance protects you and your finances from great losses in the event of any health issue or challenge. 

In Massachusetts, it is important for you to have health insurance. Being the third most expensive state in the US, health insurance policies would save you from unexpected expenses and protect your finances when you are faced with health challenges and need medical care.

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Ways To Get Health Insurance In Massachusetts

Many residents in Massachusetts can either get their health insurance coverage through their employer but if you are self-employed you can purchase yours either directly from a health insurance company, the Qualified Student Health Insurance Plan, or from the government’s provided health plans.

Qualified Student Health Insurance Plan (SHIP)

As a student enrolled in a university in Massachusetts, you can purchase a health insurance plan from the school. This is only available to students while they are enrolled.

From An Employer

Most employers in Massachusetts offer health insurance to their employees as part of their benefits. These employers pay some part of the premium and offer you several health plans to choose from. 

Directly From An Insurance Provider

As a resident in Massachusetts, you can also purchase your health plans directly from a private insurance company. Although, these companies sometimes refer you to buy through an intermediary. The intermediary takes care of the premiums and enrollment.

MassHealth 

MassHealth is a Medicaid program provided by the government in Massachusetts. This program is available only to eligible residents. You have to meet certain requirements related to age, income, and health. Those who qualify do not pay monthly premiums and deductibles, only a little amount for prescription drugs.

Medicare

This program is also a government health plan. It is available to the elderly(65 and above) and individuals with disabilities. Unlike MassHealth, Medicaid requires members to pay some amount for medical care but it’s still more affordable than private health policies.

Other Government Provided Health Plans

The federal and state governments provide lower-cost health coverage for certain individuals through public health programs. These programs include the Indian Health Services, CommonHealth, HealthyStart, peace corps, and other programs. 

Factors That Affect Rates In Massachusetts

There are some factors that health insurance companies in Massachusetts use to determine premium costs. These factors can either lower or raise your premiums. Some of them include:

Age

This factor is a major determinant of how much you pay on premiums. The older you get, the higher your premiums on health insurance. While younger ones are charged less, older people pay more to insure their health as they stand at a greater risk of being sick.

Body Mass Index

BMI is used to calculate a person’s body fat and also helps to ascertain if a person is of healthy weight. A high body mass index increases the risk of having some severe health issues like osteoarthritis, hypertension, type 2 diabetes, heart disease, and even depression.

Individuals with a high BMI are likely to be charged higher for health insurance in Massachusetts. Being able to maintain a healthy BMI would save you some money and also ameliorate your health.

Occupation

Our varying places of work expose us to different occupational hazards. While some individuals stand at greater risk of sustaining injuries and being involved in accidents, some are at minimal or no risk. This is also used by health providers in Massachusetts to determine how much your monthly premium would cost.

Smoking Habit

Smoking or the use of tobacco is dangerous and detrimental to health. Typically, smokers are charged more on health insurance as they are more liable to contract deadly illnesses or diseases.

Some of these diseases include diabetes, lung cancer, stroke, heart disease, and chronic obstructive pulmonary disease.

Other factors that affect your premium costs include geographical location, policy duration, coinsurance features, the type of policy you buy, and marital status.

Health Insurance In Massachusetts By Metal Tier

Health insurance companies in Massachusetts use a metal tier system to describe plans and the coverage they offer. The metal tier system consists of bronze, silver, gold, and platinum.

These tiers have varying monthly premiums and out-of-pocket maximums and deductibles. Also, the coverage each tier offers is different. Here is a breakdown of these tiers:

Bronze

The bronze tier/plan is the cheapest among other plans. It has the lowest monthly premiums however, it has the most out-of-pocket maxes and deductibles. The bronze plan pays up to 60% of your medical costs while you pay 40%. 

This plan is best for young and healthy people who do not visit the doctor often and do not expect high costs of medical care. Although this plan has the lowest premium, you would have to pay more when you have an emergency.

Silver

We recommend that when purchasing a health plan or policy, you start from the silver tier. Silver plans provide a great balance between the expensive platinum and gold premiums and the high out-of-pocket deductibles of the bronze plans. This plan covers up to 70% of your medical expenses and lets you pay 30%.

With the silver plan, you can qualify for cost-sharing reductions and premiums tax credits that further lower your premium cost. 

Gold

This plan offers coverage of up to 80% of your medical expenses. This means higher monthly premiums but fewer out-of-pocket maxes. It is ideal for individuals who expect high medical costs.

Platinum

This is the highest plan in the metal tier. The platinum plan has the highest monthly premiums and the least out-of-pocket maxes and deductibles. Like the gold plan, it could be the most cost-effective plan for individuals who visit the doctor frequently, have expensive prescriptions, and expect high medical expenses. 

As you continue to see the doctor, you hit your out-of-pocket limit sooner, and then your insurer steps in and begins to pay for your medical bills. This plan offers coverage for up to 90% of your medical costs.

The average monthly cost of health insurance policies in Massachusetts within a metal tier varies. They include:

  • Bronze: $403 per month
  • Silver: $533 per month
  • Gold: $634 per month
  • Platinum: $843 per month

The Most Affordable Health Insurance In Massachusetts By County

The area you reside in Massachusetts impacts the cost of health insurance. Similar to other states in the US, insurance providers in Massachusetts use rating areas to calculate policy premiums. 

There are 14 counties in Massachusetts. These counties are divided into seven rating areas. 

Middlesex is the most populous county in the state. The cheapest Silver plan there is Standard Silver: BMC HealthNet Plan Silver A II by BMC HealthNet Plan costing $354 per month.

The Most Affordable Health Insurance In Massachusetts With High Out-of-Pocket Maxes

Young people in Massachusetts who rarely need medical care could opt for low-cost plans with high out-of-pocket maxes. but the thing is you will have to spend more when you have emergencies or you begin to visit the doctor frequently within a given year. 

In Massachusetts, the most affordable health insurance for a 26-year-old buyer is Non-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance from Tufts Health Plan Direct having an average monthly premium cost of $274.

The Most Affordable Health Insurance In Massachusetts With Low Out-of-Pocket Maximums

Plans with low out-of-pocket maxes are great options if you expect high medical expenses. Your medical costs allow you to reach policy limits faster and let your insurer step in to cover your medical expenses sooner. 

The most affordable health insurance with low out-of-pocket maximums is the Standard Platinum from BMC HealthNet Plan. BMC HealthNet Plan Platinum has a premium of $538 per month on average.

Most Affordable HMO/EPO Health Insurance Plan In Massachusetts

Considering your needs and preferences would help you decide the best health policies for you. HMO and EPO plans are the most common health plans in Massachusetts.

HMO- health maintenance organization plans are usually cheaper than other plan types. However, this plan requires you to stay within your network area to ensure coverage and you require a referral to see a specialist.

The most affordable HMO silver plan is from BMC HealthNet Plan. its Standard Silver: BMC HealthNet Plan Silver A II costs an average of $367 monthly.

Exclusive Provider Organisation( EPO) plans offer the same benefits as HMO plans. They are less expensive and also require you to stay within your network coverage except in the case of emergencies. With EPO plans you do not need a referral to see a specialist.

The most affordable EPO Silver plan is the Standard Silver: UHC Navigate Silver 2000 from UnitedHealthcare. Its premium costs $588 per month on average.

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