Member Updates

What the End of Cost-Sharing Reduction Payments Means for You

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 [...]

Finish your enrollment by December 23rd for January 1, 2017 coverage

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, [...]

Moving Your Health Care When You Choose a New Plan

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 [...]

Health insurance terms to know as you Stop, Shop & Enroll

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 [...]

The Springfield MassHealth Enrollment Center and Health Connector Walk-in Center is moving

Due to the move, the current location at 333 Bridge Street in Springfield will be open limited hours on Thursday, September 29 and Friday, September 30, 2016. See the chart below for the hours: MassHealth Enrollment Center Thursday, September 29 Open 9:00 a.m.–5:00 p.m. Friday, September 30 Open 12:00 p.m.–5:00 p.m. Health Connector Walk-in Center Thursday, September 29 Open 9:00 a.m.–12:00 p.m. Friday, September 30 Closed . If you need while the location is closed during the move, you can call customer service or visit another help center location → We will re-open at our new location on Monday, October 3 at 9:00 a.m. Starting October 3, 2016, the new address will be: 88 Industry Avenue Springfield, MA 01104 The hours will be the same as the current location: Monday–Friday, 9:00 a.m.–5:00 p.m. Getting to the new location Pioneer Valley Bus Transportation: Take Route G2-Carew-East Springfield/Belmont-Dwight Road By Car (parking is available): From the NORTH: Follow I-91 South to MassPike (I-90) East to Exit 6 (Springfield). Take left onto I-291 West. On I-291, take exit 5. At the light, turn left onto Page Boulevard. Continue on Page Boulevard for a ¼ mile, then turn right onto Robbins Road. At the traffic light, Industry Avenue is straight ahead. Continue on Industry Avenue to number 88. Parking is on the left. From the EAST: Follow MassPike (I-90) West to Exit 6 (Springfield). Take left onto I-291 West. On I-291, take exit 5. [...]

Important Notice: ConnectorCare Plans in the Provider Search Tool

Please note the new Provider Directory at http://providerdirectory.mahealthconnector.org does not currently display ConnectorCare plan names at this time. The directory will be updated to include ConnectorCare plans beginning December 1, 2015. Until the site is updated, to find doctors who accept your 2016 ConnectorCare plan: First, look for a ConnectorCare Health Plan name that you are enrolled in, or are interested in purchasing. Then, in the Provider Search Tool, find the corresponding Silver Plan Name with the same provider network (see below):   Carrier 2016 ConnectorCare Plan Name Silver Plan Name with ConnectorCare Network Boston Medical Center HealthNet Plan BMC ConnectorCare 3 BMC HealthNet Plan - Silver A Boston Medical Center HealthNet Plan BMC ConnectorCare 2 Boston Medical Center HealthNet Plan BMC ConnectorCare 1 CeltiCare Health Ambetter ConnectorCare 3 Ambetter Balanced Care 14 (2016) CeltiCare Health Ambetter ConnectorCare 2 CeltiCare Health Ambetter ConnectorCare 1 Fallon Health Plan Fallon ConnectorCare 3 Community Care Silver Connector A Fallon Health Plan Fallon ConnectorCare 2 Fallon Health Plan Fallon ConnectorCare 1 Health New England HNE ConnectorCare 3 HNE Silver A Health New England HNE ConnectorCare 2 Health New England HNE ConnectorCare 1 Minuteman Health MyDoc HMO ConnectorCare 3 MyDoc HMO Silver Plus Minuteman Health MyDoc HMO ConnectorCare 2 Minuteman Health MyDoc HMO ConnectorCare 1 Neighborhood Health Plan NHP ConnectorCare 3 NHP Prime HMO Silver Simplicity Neighborhood Health Plan NHP ConnectorCare 2 Neighborhood Health Plan NHP ConnectorCare 1 Tufts Health Plan - Direct Tufts Health Direct ConnectorCare 3 Direct Silver 2000 with Coinsurance Tufts Health [...]

Infographic: Open Enrollment Preparedness and Customer Service

The Massachusetts Health Connector is committed to helping our state’s residents find the right health insurance. In preparation for the Open Enrollment period, November 1, 2015 through January 31, 2016, the Health Connector has dedicated additional resources to the customer service experience. Check out the infographic below to learn how:  

Upcoming Maintenance Schedule for the week of August 24, 2015

The Health Connector online application is scheduled for planned maintenance during the week of August 24, 2015. During the following maintenance periods, you will not be able to access your application. We apologize for the inconvenience. Maintenance Start Time Maintenance End Time Monday, August 24 at 6:30 p.m. Tuesday, August 25 at 7:00 a.m. Tuesday, August 25 at 9:00 p.m. Wednesday, August 26 at 12:30 a.m. Wednesday, August 26 at 6:30 p.m. Thursday, August 27 at 6:30 a.m. Thursday, August 27 at 6:30 p.m. Friday, August 28 at 6:30 a.m. Friday, August 28 at 6:30 p.m. Saturday, August 29 at 6:30 a.m.   Please note that the above schedule is subject to change.

Special Enrollment Period

Did you know you may still qualify for coverage through the Massachusetts Health Connector? You may qualify to enroll in coverage at any time of the year. Continue reading the article to learn more.

Stay healthy with your new insurance

Getting health insurance is an important first step in getting and staying healthy. Follow these guidelines to make sure you are taking care of your health and your coverage.   #1 – Understand your health coverage Check with your insurance plan to see what services are covered, and know whether you will need to pay out of pocket for any services. Be familiar with your costs (premiums, co-payments, deductibles, co-insurance). Know the difference between in-network and out-of-network providers. Know where and when to send payments for your monthly health insurance premium from the Health Connector.   #2 – Know where to go for care Use the emergency department only for life-threatening situations. Use your doctor for preventive health or when it’s not an emergency. Did you know that because of national healthcare reform, most health plans must cover a set of preventive services like shots and screening tests at no cost to you? Find out more about preventive services for adults, women, and children at https://www.healthcare.gov/preventive-care-benefits/adults/   #3 – Find a provider Ask people you trust and/or do research on the internet. Check which providers are in your network by searching on your health plan’s website or calling your health plan’s customer service number. If you’re assigned a provider and you want to change, call your health plan.   #4 – After you have an appointment with a provider Follow your provider’s instructions. Fill any prescriptions you were given, and take them as directed. Review your explanation of [...]

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