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What’s the difference between the Health Connector and MassHealth?

We’ve heard questions from many members over the years who are confused about the difference between MassHealth and the Health Connector. Here’s a quick overview of the differences between these two separate state agencies: Massachusetts Health ConnectorWhere people who don’t get coverage through a job can buy a health or dental plan Where people with any level of income can buy a health plan The only place where people can get access to special programs to save money on health insurance if they qualify MassHealthWhere people can get free and low-cost health coverage if they qualify based on income level, a disability, pregnancy, or chronic (long-term) illness How are the agencies connected?One application for coverageWhen people apply for coverage at MAhealthconnector.org, they fill out one application to find out if they qualify for coverage through MassHealth, the Health Connector, or both. People or families can have a mix of coverage from both agenciesFor example, a family could have parents covered by the Health Connector with children who are covered by MassHealth. Or a person may get temporary benefits from MassHealth (called Health Safety Net) that cover some services before their Health Connector enrollment starts.Who do I call for help?If you need help with MassHealth benefits, call the MassHealth contact center at 1-800-841-2900, or TTY 1-800-497-4648. This is a separate call center from the Health Connector.If you need help with Health Connector coverage, call the Health Connector at 1-877-MA-ENROLL (1-877-623-6765), or TTY 711.

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What to Know If You Get Help Paying for Health Insurance from Both the Health Connector and Your Employer

Overview A Health Reimbursement Arrangement, or HRA, is an employee health benefit from your employer that reimburses you for your health care expenses up to a certain dollar amount. There are several types of HRAs. This page focuses on two types: Individual Coverage HRAs (ICHRAs) and Qualified Small Employer HRAs (QSEHRAs).If you are offered one of these types of HRAs, you should have received a clear notice from your employer explaining the terms of the Individual Coverage HRA or the QSEHRA. The type of HRA will appear prominently on that notice.If your employer offers an Individual Coverage HRA or a QSEHRA instead of a traditional employer health insurance plan, you can use it to help pay your monthly premiums for a health plan purchased through the Health Connector. However, these types of HRAs might affect your tax credit eligibility. When completing the Health Connector application for health coverage, be sure to enter any information about your individual coverage HRA or QSEHRA from your employer. The Health Connector’s application includes questions about  employer offered HRAs and uses this information to determine your eligibility for tax credits through the Health Connector.Keep your application information up to date. If your income changes, you should update the information you gave us about your expected income in your application. If your employer stops offering an Individual Coverage HRA or a QSEHRA, you should update your application since that may affect your tax credit eligibility.You can read more below about Individual Coverage HRAs and QSEHRAs. [...]

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Hardship exemption and how to apply

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 711 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 [...]

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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 if my income changes during the year? How will that affect my eligibility for a tax credit?

It’s common for income to change throughout the year, particularly if you are self-employed, have a seasonal job, or more than one job. To get the most accurate tax credit amount, you should let the Health Connector know if you have any income changes during the year, as they happen. If you expect your income to go up during the year, you may want to consider changing the amount of tax credit that you apply to your monthly premiums, so that you take less than the full amount available to you. If you use your tax credit during the year and your actual income is over the amount that makes you eligible, you may need to pay back some or all of the credit. You always have the option of waiting until you file your taxes next year to take the credit on your tax return, instead of applying it to your premiums in advance. This may make sense for you if you aren’t sure what your income will be for the year, and are concerned about having to pay money back at tax time.

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Do I have to buy through the Health Connector if I want to get help paying for insurance?

Yes, help paying for insurance through tax credits and low-cost ConnectorCare plans is only available through the Health Connector. Even if you enroll in a plan without help paying for it through the Health Connector, if you end up qualifying for a tax credit based on your income for that year, the IRS will let you to claim the tax credit when you file your taxes at the end of the year. But the tax credit is not available for someone who buys a plan outside of the Health Connector. You can also apply through the Health Connector website to see if you qualify for MassHealth coverage.

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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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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, 2025. 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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