The Commonwealth of Massachusetts requires that all individuals (with certain exceptions) have health insurance. Advocacy for Access can help you apply for coverage.
The various programs available to Massachusetts residents can cover the cost of:
The cost of the coverage depends on your annual household income. Some health coverage programs only require small co-payments (money you pay each time you use certain healthcare services). Other health coverage programs have a monthly premium (money you pay each month) and co-payments.
How Do I Apply?
Please walk-in or schedule an appointment with one of our offices. The information you will need to apply may include:
What Programs Are Available?
The following are some of the health coverage programs available to residents of Massachusetts:
In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are combined into one program called MassHealth. MassHealth provides health care for certain low- and middle-income people living in Massachusetts. MassHealth offers different types of coverage based on your age, whether you are a parent, pregnant, disabled, HIV positive, or have breast or cervical cancer. MassHealth members receive coverage for doctors’ visits, prescription drugs, hospital stays, and many other important services.
ConnectorCare Health Plans
ConnectorCare plans are affordable health insurance plans offered through the Massachusetts Health Connector. They have low monthly premiums and low out-of-pocket costs, with no deductibles. They are available to individuals who do not qualify for MassHealth, do not have access to affordable coverage through an employer, do not have access to government sponsored minimum essential coverage (Medicare, Tricare, Veterans Benefits), and have a household income that is less than 300% of the Federal Poverty Level.
Qualified Health Plans
A Qualified Health Plan (QHP) is a health insurance plan available through the Massachusetts Health Connector. Qualified Health Plans meet minimum coverage standards and make it possible for Massachusetts residents to get quality, affordable health coverage for themselves and their families. Households under 400% of the Federal Poverty Level may receive premium tax credits to help pay the cost of these plans.
Health Safety Net
The Health Safety Net is a fund set up to help pay for health services for certain low income uninsured and underinsured individuals. The Health Safety Net used to be called the Uncompensated Care Pool (UCP), or Free Care.
You can use the Health Safety Net at hospitals and community health centers. However, at most hospitals, the doctors bill separately. The Health Safety Net will pay for hospital facility charges (for example beds, nurses, and equipment), but you may have to pay bills for the doctors and for services like lab tests and x-rays. Be sure to check with your doctor first to see if the Health Safety Net will cover all the services you receive, or just some.
Children’s Medical Security Program
The Children's Medical Security Plan (CMSP) is a program that provides certain uninsured children and adolescents - who do not qualify for MassHealth - with primary and preventive medical and dental coverage.
MassHealth helps eligible members pay for their health insurance by sending them monthly payments. Eligibility for Premium Assistance is determined by the individual’s MassHealth coverage type and the type of health insurance that the individual has access to or is enrolled in.
HSN Medical Hardship
An individual can qualify for Medical Hardship through the Health Safety Net if his or her medical expenses incurred within the past year exceed a specific percentage of family income. A Massachusetts resident at any income may qualify for medical hardship.
MassHealth Buy-In (Medicare Savings Program)
The Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs are federal Medicare Savings Programs (MSPs) which help low income elders and younger Medicare beneficiaries access Medicare benefits. In Massachusetts, the programs are called MassHealth Senior Buy-In (for QMBs) and MassHealth Buy-In (for SLMBs and QIs). Qualifying individuals will receive help paying for their Medicare premiums and are automatically enrolled in Extra Help.