Applying for Coverage

Upload Documents (Proof)

When you apply for coverage, renew, or update your information, you may be asked to send proof of some information that could not be electronically verified. Your proof can be sent to the Health Connector and MassHealth By uploading online through your account. By Mail, By Fax, and Bringing documents in-person to a MassHealth Enrollment Center or Health Connector Walk-in Center. Important: If you are sending proof, don't send the same document in more than one way. For example, don't fax and upload the same document for proof. How to upload your documents Step 1 Sign in to your online account. (If you don't have an online account or or locked out, call Customer Service for assistance.) Step 2 In the main menu of your account, go to "Documents." This will take you to the Manage Documents page. Step 3 On the Manage Documents page, click the "Upload Documents" button, which will take you to the upload interface. If you submitted proof before, you may see those documents listed on the page. Step 4 Drag and drop your files, or you can click the "Browse" link and go to where your documents are saved on your computer or mobile phone to upload. If you use the "Browse" link, use your device's file browser to add your documents. While you can submit up to 5 documents at a time, each file must be uploaded one at a time. Supported file formatsBitmap Image File (.bmp)Portable Document Format File (.pdf)Graphical Interchange Format File [...]

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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 Credit to lower your month premium costs, or 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 a qualifying range above 100% the 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 [...]

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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 [...]

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Important information about identity (ID) proofing

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 [...]

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What is the best way to apply for coverage?

The fastest way to apply is through the online application. If you would like help applying for insurance, you can get free help with an Enrollment Assister organization in your area. Find a location near you →You may also apply by phone by calling customer service at 1-877 MA ENROLL (1-877-623-6765) or TTY: 711.You can also apply through a paper application. Download a copy of the paper application from the Forms page or call 1-877 MA ENROLL (1-877-623-6765) or TTY: 711 to have a paper copy mailed to you.

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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.

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When can I apply for coverage?

In general, an open enrollment period is the time of year when people applying for health insurance can enroll or change a plan for any reason. The next Open Enrollment for Massachusetts begins November 1, 2024. If you qualify for help paying for coverage through programs like MassHealth or a ConnectorCare plan, or experience a qualifying life event, you may 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, becoming a citizen, national, or lawfully present individual, or getting a waiver from the Office of Patient Protection. For more information on qualifying events, go to our Closed Enrollment information page.

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How is income now measured for determining who can get help paying for insurance?

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 8b on their Form 1040 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.

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What are ConnectorCare plans?

ConnectorCare plans are a set of plans that offer lower monthly premiums and lower out-of-pocket costs, because they are partially paid for by the state. If you qualify for a ConnectorCare plan, you will be able to get the most savings possible. Learn more about ConnectorCare plans

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