Resource Guides

2026 ConnectorCare Plan Shopping Guide

Use this guide to help you choose a ConnectorCare health insurance plan for 2026 through the Massachusetts Health Connector.

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Step 1: Know which plans are available to you

First, you’ll need to know which plans are available to you, based on where you live. You can find the list of ConnectorCare plans available in your area on the letter that came with this guide. You can also find this information in your online account.

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Step 2: Compare monthly premium costs

Your ConnectorCare plan choices have different monthly premium costs, depending on the insurance company offering the plan. Covered benefits are the same for all ConnectorCare plans, but out-of-pocket costs may be different based on Plan Type.

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Step 3: Check for your providers and prescription medicines

It’s very important to check to see if providers you want to use for care (such as doctors, hospitals, or health centers) and any prescription medicines you need are covered by a plan before you enroll. To find out which ConnectorCare plans cover your providers and prescription medicines, use our online Plan Finder tool.

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Step 4: Choose your new plan and enroll

Once you choose a plan, you can enroll online through your account, or call Customer Service to enroll by phone. You’ll need to pay your first premium (if you have one) to complete enrollment. Payment is always due by the 23rd of the month before your coverage begins.

Questions to help you get started

Write down your answers to the questions below before you start shopping for health insurance. Your answers will help you decide which ConnectorCare health plans are best.

Do you have prescription medications that you and anyone on your plan take regularly?

If so, for each medicine note down:

  • Medicine’s exact name
  • The number of pills or doses that you have filled at the pharmacy each month

Before you enroll in a plan, check to make sure the plan covers all of your medicines and find out what their cost would be.

Are there any doctors or specialists that you or anyone on your plan will want to be able to see for appointments?

If so, make a list of those doctors, therapists, nurse practitioners, and specialists.

Do you have a hospital or health center that you or anyone on your plan will want to be able to go to if you need care?

If so, note down the names of the hospitals or health centers you use.

Before you enroll in a plan, check to make sure the providers you want and the places you get health care are in the plan’s network.

Glossary of Terms

Below is a list of terms you will see and hear when choosing your health plan. These terms may be new to you. Learning them will help you better understand your health 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.

A fixed price you pay when you get certain health care services. Not all services require a co-pay.

Health care services are things like going to the doctor, getting a prescription filled, or having an operation.

The most you pay in one year for health care services. Once you pay this, your plan pays for all of your covered services for the rest for the year.

There are different ConnectorCare Plan Types that you may qualify for, based on your household size and income. All of the plans in each Plan Type have the same costs for covered benefits.

The amount you pay each month for your health insurance. You must pay your premium every month, whether or not you use health care services. Your premium will always be due by the 23rd of the month.

The primary (main) doctor that you go to for care. If you need a specialist, your PCP will coordinate that care and give you a referral.

A provider network is a group of doctors, hospitals and other providers that works with the health plan to give you care. Before you enroll, make sure any providers you want to use are in the plan’s provider network. If you get care from a provider that is not in the plan’s network, you could have to pay out-of-pocket for all or part of the costs.

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Answers to help you choose a plan

1. What benefits do the health plans cover?

All of the ConnectorCare health plans you can choose offer these health benefits:

  • Outpatient care – Treatment you get without being admitted to a hospital
  • Inpatient care – Treatment you get in the hospital
  • Emergency room – Treatment you get in an emergency room
  • Prenatal and postnatal care – Care before and after your baby is born
  • Mental health and substance use disorder services – This includes behavioral health treatment, counseling, and psychotherapy
  • Prescription drugs – These are medications prescribed by your physician that you take at home
  • Services and items to help you recover if you are injured, or have a disability or chronic condition – This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more
  • Lab tests – These include tests such as blood work or Pap smears
  • Preventive services – Services to help keep you healthy, like counseling, screenings, and vaccines
  • Pediatric services – Services for children, including vision care

2. How do the health plans differ?

Differences between plans include:

  • Which health insurance company offers the plan
  • Provider networks (the doctor, hospitals, and other providers in the plan)
  • Monthly premium
  • Prescription medicines covered by the plan

Before you enroll, go to PlanFinder.MAhealthconnector.org and use our online tools to make sure the providers you want and the medicines you need are in the plan’s network. You can use this tool to check the cost of your prescriptions. You can also call the insurance company directly for this information.

Note: When you search or call an insurance company to ask about a provider, be sure to give the plan’s full name.

3. What kinds of costs do ConnectorCare health plans have?

There are three kinds of costs in ConnectorCare health plans:

  • Premium: This is the cost you pay each month, whether or not you use health care services. You will pay your monthly premium bill to the Health Connector. The premium is always due by the 23rd of the month. To find out more about payments, visit MAhealthconnector.org/how-to-pay.
  • Co-pay: This is the cost you pay at the time you get certain health care services.
  • Maximum out-of-pocket cost (MOOP): This is the most you pay in one year for health care services. Once you pay this amount, your plan will pay for all of your covered services for the rest of the year. For ConnectorCare, there is a MOOP for the cost of prescription medications and a separate MOOP for the costs of other health care services.

Compare ConnectorCare health plans

2026 Monthly ConnectorCare Plan Premiums (per person)

Plan Type 2A 2B 3A 3B 3C
Lowest cost plan $0 $53 $103 $152 $235

ConnectorCare Benefits and Co-pays

Benefit Plan Type 2A & 2B Plan Type 3A, 3B & 3C
Medical maximum out-of-pocket (individual / family) $750 / $1,500 $1,500 / $3,000
Prescription drug maximum out-of-pocket (individual / family) $500 / $1,000 $750 / $1,500
Preventive care/screening/immunization $0 $0
Primary care visit to treat injury or illness $0 $0
Specialist office visit $18 $22
Mental/behavioral health and substance abuse disorder outpatient services $0 $0
Rehabilitative speech therapy $10 $20
Rehabilitative occupational and rehabilitative physical therapy $10 $20
Emergency room services $50 $100
Urgent care $18 $22
Outpatient surgery $50 $125
All inpatient hospital services $50 $250
High cost imaging (CT/PET scans, MRIs, etc.) $30 $60
Laboratory outpatient and professional services $0 $0
X-rays and diagnostic imaging $0 $0
Skilled nursing facility $0 $0
Retail prescription drug Plan Type 2A & 2B Plan Type 3A, 3B & 3C
Generics $10 $12.50
Preferred brand drugs $20 $25
Non-preferred brand drugs $40 $50
Specialty high-cost drugs $40 $50

Need help?

You can get free, in-person help with an Enrollment Assister at a community partner organization near you.

Enrollment Assisters are people who have been trained to help you with applying and enrolling through the Health Connector.

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