Eligibility

Your coverage end date and renewing your coverage

When you buy health and dental insurance through the Health Connector, your coverage period ends on December 31 regardless of your coverage start date. But, don’t worry. You have the opportunity to review coverage each year during the Open Enrollment period. The past Open Enrollment period ended January 23, 2019. The 2020 Open Enrollment period will be announced mid-2019. Before your coverage end date for the year, you will get letters in the mail that will let you know about your coverage options for the next year. Your plan renewal information will tell you if your plan will be available for the next year, or, if it is not, will give your information about the new plan you are matched to. During open enrollment you can shop for a different plan, even if the plan you have is available. By shopping during open enrollment, you may be able to find plans with lower costs. If your plan is available for the next year and you do not want to change it, then all you have to do is continue to pay your monthly premium. About plan premiums It is important to know that plan premiums change each year. Premiums are calculated based on The ages of covered household members, The number of people covered on the plan, Where you live, and Rates set by health insurers, approved by the Massachusetts Division of Insurance If you are eligible for savings that help lower your monthly premium cost, this may change, too. [...]

Monday, April 2nd, 2018|

Can I get help paying for health insurance through the Health Connector?

If you are applying for health coverage and are not sure if you qualify for help paying for your insurance, we offer a tool to help you estimate if you may be eligible. To use this tool: Go to the login landing page here. On that page, you will see a section that reads "See What You May Qualify For" Enter your zip code, select a coverage start date and choose "Yes" to the question "Do you want to check to see if you are eligible for help paying for costs?" Click "Start Now" to use the tool, answering all the questions on the following pages. Remember: The results from the tool is only an estimate of what you may qualify for. You will need to complete an application to get your actual eligibility decision. You may qualify if you: Shop through the Massachusetts Health Connector Live in Massachusetts Are a U.S. citizen, national, or are otherwise lawfully present in the U.S. Have income that is 400% of of the Federal Poverty Level (FPL) or or lower (see chart below) You won’t be able to qualify if you: Get coverage through Medicare, MassHealth (Medicaid), or other public health insurance programs Are in jail at this time Are offered affordable, comprehensive health insurance from an employer. Note: If the cost of your employer’s health insurance plan for individuals is more than 9.56% of your income, then that coverage is not considered affordable. Household [...]

Tuesday, December 19th, 2017|

Why don’t I qualify for subsidies?

If you completed an application or renewal and are eligible for a Health Connector plan, but were not approved for an Advance Premium Tax Credits to lower your month premium costs, or a ConnectorCare plans, this could be for one of the following reasons: You did not select the option to complete an application for coverage and help paying for costs. How to troubleshoot: Sign into your account and update your application by following the steps here and select "Change application type" on the "Change Your Information" page of your application. Your income is not in the range of 100% to 400% Federal Poverty Level. Note that income can be below 100% FPL if applicant has a certain qualified immigration status. If your income is below 100% FPL and does not have a certain qualified immigration status, member cannot be eligible for subsidies How to troubleshoot: You can, first, check your income with the Federal Poverty level chart. Then, sign into your account and check that your income was reported correctly by reviewing your application summary. If you need update your income, you can find a help guide here and even more details and calculator on how to add different types of income in this guide.  To update your income, you can find a guide here. You have access to, or are enrolled, in affordable employer sponsored insurance that meets minimum value standards. How to troubleshoot: If you have access to health insurance through [...]

Monday, May 15th, 2017|

Federal Poverty Level (FPL)

The Federal Poverty Level, or FPL, is a measure of income level published each year by the Department of Health and Human Services. Federal poverty levels are used to help determine your eligibility for certain programs and benefits. The 2019 Federal Poverty Levels are used to determine who may be currently eligible for MassHealth programs. The 2018  Federal Poverty Levels are used to determine who may be eligible for Health Connector or ConnectorCare plans. 2019 MassHealth Income Standards and Federal Poverty Guidelines Family Size MassHealth Income Standards 100% Federal Poverty Level 5% Federal Poverty Level 120% Federal Poverty Level 133% Federal Poverty Level 135% Federal Poverty Level 1 Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly $522 $6,264 $1,041 $12,492 $53 $636 $1,249 $14,988 $1,385 $16,620 $1,406 $16,872 2 $650 $7,800 $1,410 $16,920 $71 $852 $1,691 $20,292 $1,875 $22,500 $1,903 $22,836 3 $775 $9,300 $1,778 $21,336 $89 $1,068 $2,365 $28,380 4 $891 $10,692 $2,146 $25,752 $108 $1,296 $2,854 $34,248 5 $1,016 $12,192 $2,515 $30,180 $126 $1,512 $3,344 $40,128 6 $1,141 $13,692 $2,883 $34,596 $145 $1,740 $3,834 $46,008 7 $1,266 $15,192 $3,251 $39,012 $163 $1,956 $4,324 $51,888 8 $1,383 $16,596 $3,620 $43,440 $181 $2,172 $4,814 $57,768 For each additional person add $133 $1,596 $369 $4,428 $19 $228 $490 $5,880 Family Size 150% Federal Poverty Level 200% Federal Poverty Level 250% Federal Poverty Level 300% Federal Poverty Level 400% Federal Poverty Level 1 Monthly Yearly Monthly Yearly Monthly Yearly Monthly Yearly Monthly [...]

Monday, March 13th, 2017|

What is Minimum Essential Coverage?

Minimum essential coverage, or MEC, is any insurance that meets the Affordable Care Act (ACA) requirement for having health coverage. If you have MEC, you don’t have to pay the fee for being uninsured. Examples of health coverage that qualifies as MEC include: Most MassHealth coverage; A Health Connector or ConnectorCare plan; Insurance from a job, including COBRA; Medicare Part A or Part C; Most student health insurance plans; Some other types of coverage recognized by the Secretary of the U.S. Department of Health and Human Services as minimum essential coverage (MEC). See a full list of what coverage qualifies as MEC in the chart below. Minimum Essential Coverage Chart See the original chart and more information on the Individual Shared Responsibility Provision on the IRS website → Coverage Type Qualifies As Minimum Essential Coverage? Employer-sponsored coverage: Group health insurance coverage for employees under – A governmental plan, such as the Federal Employees Health Benefit program A plan or coverage offered in the small or large group market within a state A grandfathered health plan offered in a group market A self-insured group health plan for employees COBRA coverage Retiree coverage Coverage under an expatriate health plan for employees Yes. Qualifies as MEC Individual health coverage: Health insurance you purchase directly from an insurance company Health insurance you purchase through the Health Insurance Marketplace Health insurance provided through a student health plan Catastrophic plans Coverage under an expatriate health plan for non-employees such as [...]

Wednesday, July 20th, 2016|

What if my income changes during the year? How will that affect my eligibility for a tax credit?

It’s common for income to change throughout the year, particularly if you are self-employed, have a seasonal job, or more than one job. To get the most accurate tax credit amount, you should let the Health Connector know if you have any income changes during the year, as they happen. If you expect your income to go up during the year, you may want to consider changing the amount of tax credit that you apply to your monthly premiums, so that you take less than the full amount available to you. If you use your tax credit during the year and your actual income is over the amount that makes you eligible, you may need to pay back some or all of the credit. You always have the option of waiting until you file your taxes next year to take the credit on your tax return, instead of applying it to your premiums in advance. This may make sense for you if you aren’t sure what your income will be for the year, and are concerned about having to pay money back at tax time.

Tuesday, May 12th, 2015|

Do I have to buy through the Health Connector if I want to get help paying for insurance?

Yes, help paying for insurance through tax credits and low-cost ConnectorCare plans is only available through the Health Connector. Even if you enroll in a plan without help paying for it through the Health Connector, if you end up qualifying for a tax credit based on your income for that year, the IRS will let you to claim the tax credit when you file your taxes at the end of the year. But the tax credit is not available for someone who buys a plan outside of the Health Connector. You can also apply through the Health Connector website to see if you qualify for MassHealth coverage.

Tuesday, May 12th, 2015|

Do I qualify for free or low-cost coverage?

To find out what you are eligible for, complete an eligibility application online (click "Get Started" to begin), by phone at 1-877-MA-ENROLL (1-877-623-6765), TTY 1-877-623-7773, or with the help of a local Navigator or Certified Application Counselor .

Tuesday, May 12th, 2015|