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 [...]
If you are over age 30 and have applied for and was approved for a federal hardship exemption, you may be able to shop for a Catastrophic plan. For information about the federal hardship exemption, including how to apply, go to the hardship exemption page on HealthCare.gov → Were you already approved for a federal hardship exemption? If you have a federal hardship exemption and want to shop for a Catastrophic health insurance plan through the Health Connector, please call Health Connector customer service at 1-877-MA-ENROLL (1-877-623-6765), or TTY 1-877-623-7773 for people who are deaf, hard of hearing, or speech disabled. Health plans that meet all of the requirements applicable to other Health Connector plans but that don't cover any benefits other than 3 primary care visits per year before the plan's deductible is met. The premium amount you pay each month for health care is generally lower than for other health plans, but the out-of-pocket costs for deductibles, co-payments, and co-insurance are generally higher. To qualify for a Catastrophic plan, you must be under 30 years old OR get a "hardship exemption" because the Marketplace determined that you’re unable to afford health coverage. Catastrophic health plans: For people under 30 or with certain exemptions Catastrophic health insurance plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself. Who can buy a [...]
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 2018 Federal Poverty Levels are used to determine who may be currently eligible for MassHealth programs. The 2017 Federal Poverty Levels are used to determine who may be eligible for 2018 Health Connector or ConnectorCare plans. The 2018 Federal Poverty Levels are used to determine who may be eligible for 2019 Health Connector or ConnectorCare plans. 2018 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 $1,012 $12,144 $51 $612 $1,214 $14,568 $1,346 $16,152 $1,366 $16,392 2 $650 $7,800 $1,372 $16,464 $69 $828 $1,646 $19,752 $1,825 $21,900 $1,852 $22,224 3 $775 $9,300 $1,732 $20,784 $87 $1,044 $2,304 $27,648 4 $891 $10,692 $2,092 $25,104 $105 $1,260 $2,782 $33,384 5 $1,016 $12,192 $2,452 $29,424 $123 $1,476 $3,261 $39,132 6 $1,141 $13,692 $2,812 $33,744 $141 $1,692 $3,740 $44,880 7 $1,266 $15,192 $3,172 $38,064 $159 $1,908 $4,219 $50,628 8 $1,383 $16,596 $3,532 $42,384 $177 $2,124 $4,698 $56,376 For each additional person add $133 $1,596 $360 $4,320 $18 $216 $479 $5,748 Family Size 150% Federal Poverty Level 200% Federal Poverty Level 250% Federal Poverty Level 300% Federal Poverty [...]
What is ID proofing? ID proofing is one of the first steps of the process to apply for health coverage through the Health Connector website and is required by the Affordable Care Act (ACA). ID proofing is used to verify your identity by asking you customized questions based on your personal and financial history to protect your privacy and information and prevent fraud. Id proofing is performed through external services How ID proofing works To protect your personal information, you have to take a few steps to verify your identity before you can complete an application. First you will provide information when you create your profile. This information will be used for the first step of ID proofing. Once your information is verified, the ID proofing process will ask you questions that only you would be likely to know the answers to, based on your financial accounts and personal information in your credit report. This process is meant to prevent an unauthorized person from creating an account and applying for health coverage in your name without your knowledge. The ID proofing service will show you several multiple choice questions for you to answer. These questions will be based on Credit and Non-Credit information. Sample question types include: Auto Loan Lender (Credit) Previous Street Name (Non-Credit) Last 4 digits SSN (Non-Credit) Employer Name (Credit) Year of Birth (Credit) Previous Address (Non-Credit) Previous Phone Number (Non-Credit) If your identity cannot be verified online, we need to receive proper documentation such as [...]
Eligibility for help paying for insurance is no longer determined by your gross (total) income. Under national health reform, Modified Adjusted Gross Income (MAGI) is now used instead. Under MAGI you can factor in business expenses that you write off for tax purposes (your Schedule C losses) when calculating your income. This means that many more people may qualify for help who might not have been able to get it in the past. Most people can look at their adjusted gross income (line 37 on their income tax return) to see what their MAGI number will most likely be. This is an important change to understand for those who are self-employed or have combination income sources that include self-employment income.
In general, an open enrollment period is the time of year when people who are applying for health insurance can enroll or change a plan for any reason. The next open enrollment period is November 1, 2018, and run through January 23, 2018. However, if you can qualify for help paying for coverage through programs like MassHealth or a ConnectorCare plan, or experience a qualifying life event, you may be able to enroll at any time during the year. If you do not qualify for help paying for coverage, there are certain qualifying events that allow you to enroll in coverage at other times during the year. Qualifying events include (but are not limited to): adding a dependent through birth or marriage, moving to a new permanent address in Massachusetts, or becoming a citizen, national, or lawfully present individual. For more information on qualifying events, go to our Closed Enrollment information page.
Who can shop as a business, and who needs to shop as an individual or family through the Health Connector?
The rules around shopping as a small business through the Health Connector have changed. If you are the owner of a business that has no eligible employees other than your tax dependents, you will need to shop as an individual or family, instead of as a small business. However, most of the health plans available to small businesses are the same as the health plans offered to individuals through the Health Connector. And, you may be able to qualify for help paying for your coverage through programs that are available only for individuals and families.
Under both Massachusetts and national health reform laws, most people must have health insurance if it’s affordable to them. There can be penalties for not being insured.
Yes, when you apply, you will be able to find out which programs you can qualify for. The three main ways to get help paying for coverage are through MassHealth (Massachusetts’ Medicaid program), ConnectorCare health plans, and tax credits that lower your monthly insurance premium. All applications for help paying for coverage can be submitted through this site, or by filling out a paper application that is used by both the Health Connector and MassHealth.
National health reform raises income limits for people who can qualify for help paying for health insurance. Individuals and families earning up to 400% of the federal poverty level (FPL) who do not otherwise have access to affordable health insurance from an employer or other program may qualify for a tax credit to lower their monthly premium. Here are some examples of the types of household and income levels that are within 400% of the FPL: Individuals earning up to about $46,680 a year A family of two earning up to about $62,920 a year A family of three earning up to about $79,160 a year A family of four earning up to about $95,400 a year