Member Updates

We understand that recent national news about the elimination of federal Cost-Sharing Reduction payments—or CSRs—may be confusing for members. To help members understand who may be impacted and what they should do, we have provided this guide to help you understand if you are impacted and what to do. What are Cost-Sharing Reduction payments? Cost-Sharing Reduction payments—or CSRs—are made by the federal government directly to health insurance carriers to help lower the cost of certain Silver tier plans for lower-income consumers. This discount helps lower the amount have to pay for deductibles, co-payments, and co-insurance, making Silver tier health plans more affordable for families who household income is 100% to 250% the federal poverty level. (This is an income range of about $24,600 to $61,500 per year for a family of four.) Are CSRs the same as Advance Premium Tax Credits? No. The Advance Premium Tax credit, or APTC, is a separate subsidy eligible members receive to help make insurance more affordable. APTC is a federal tax credit that—unlike tax credits you claim when you file your taxes—can be used right away to lower your monthly premium costs. This tax credit is not impacted by the recent Executive Order to end Cost-Sharing Reduction payments and will still be available for families who qualify. So, what does it mean for me now that Cost-Sharing Reduction payments are no longer available? To protect coverage for most members for 2018, the Health Connector has allowed for [...]

If you are renewing your health insurance through the Health Connector for 2017, or are applying for the first time, the deadline to complete your enrollment for coverage that starts January 1 is December 23, 2016. Take action now to be sure that you’ve completed these steps to finish your January 1st enrollment: Complete all of the required information to find out what type of coverage or savings you qualify for, like tax credits, a ConnectorCare plan, or MassHealth. Make sure your information is as up-to-date as possible if you are a renewing member. If you qualify for a Health Connector or ConnectorCare plan, you can use our Shopping Guides and new Provider Search tool to help find a quality health and dental plan to meet your needs and budget. Once you choose a plan, you must make your first premium payment, in full, by December 23, 2016 for your coverage to start January 1, 2017. You can set up monthly recurring payments online so your bill will always be paid on time each month. There are 4 ways to make a payment. Learn about them now → If you are a renewing member and have already set up automatic recurring payments, then you do not need to set up a new recurring payment. Your new premium will be deducted on December 22nd, even if you enrolled in a plan with a different insurance company.  Congratulations. Once you have finished your enrollment, [...]

Are you shopping for a new health plan this Open Enrollment? Use our Health Connector Shopping Guides to help you think about your health plan options this Open Enrollment. If you choose a new health plan, take these steps to transition (move) your health care from the health insurance plan you have now to your new health plan. In this post: What are the first steps I should take to transition (move) my health care to a new health insurance plan? What if I already scheduled surgery, tests, or doctor visits for after my new plan starts? What if my doctor or hospital is not covered through my new plan’s network? What if my medication is not covered through my new plan? What should I do when my new plan starts? What if I followed these steps, but am having trouble accessing health care in my new plan? How can I contact my new health plan with questions? What are the first steps I should take to transition (move) my health care to a new health insurance plan? If you need to change health care providers (such as doctors and hospitals you use) under your new plan, you may want to: Make sure you have enough refills on your prescriptions to last until your new plan starts and your new doctor can write you a prescription. Ask your current doctor or health plan for copies of your medical records, including any prior authorizations or referrals [...]

Not really sure what an HMO really is? Do you only “Kinda, sorta” understand deductibles? Health insurance seems to have a language of its own and you want to be sure you’re choosing the right plan. Here, we’ll try to help you by explaining some of the most common terms you’ll see while you’re shopping for insurance. Co-insurance If a health care service has co-insurance, you pay a percentage (part) of the cost for that service. Usually, you start to pay co-insurance after you meet your deductible. It is not a fixed cost like a co-pay. The amount you pay depends on the total cost of the service. Co-pay A fixed price you pay when you get certain health care services. Not all services require a co-pay. Deductible The total amount you must pay in a plan year before your plan will pay for part or all of your services. Some services may not have a deductible. They may be free or just have a co-pay, even though you haven’t met the deductible yet. HMO HMO stands for Health Maintenance Organization. If you choose a plan that is an HMO, you must use in-network providers in order to get your services covered. If you go to an out-of-network provider, the plan won’t cover the cost of your care, except in an emergency. If you enroll in [...]