MassHealth is a state-run medical insurance plan in Massachusetts that provides coverage for a wide variety of medical procedures, as well as some preventive care, for those who make too much money to qualify for private health care insurance but can’t afford to pay for out-of-network health care costs. Unlike private plans, which have annual deductibles and co-pays, MassHealth does not have deductibles. There are no premiums to be paid, and there are also no co-pays. When considering a MassHealth quote, it’s important to understand what kinds of services are covered and what services aren’t. For example, there are some health conditions that are usually covered in a MassHealth plan, such as asthma, cancer, epilepsy, heart conditions, and childhood illnesses like allergies and diabetes.
MassHealth provides standard coverage as well as some types of dental and vision care. Some plans also include extended health care benefits for mental health, alcohol or drug abuse, depression, and obesity. In order to receive these extended services, you must be eligible. MassHealth plans are state-paid health plans, and you are required to have one regardless of whether you are eligible for Mass Health Care as a Massachusetts resident or not. As an uninsured Massachusetts resident, it’s always best to get your family covered by a mass health care plan, as these plans have very low or zero cost co-pays or deductibles for most insurance policies.
Mass health coverage depends on your income and family size. There are two primary types of mass health plans in Massachusetts: Medicaid and private, insurance-based Medicare programs. Mass health plan eligibility depends on your income. Infants, children, teenagers, and single adults who don’t qualify for federal Medicaid (medical aid for certain families), or who don’t meet the health care eligibility requirements for Mass Health Care as a Massachusetts resident, are considered qualified for federal Medicaid. If you are a resident of the Unites States, you can apply for Medicaid at the state level.
In Massachusetts, both the state and federal governments provide most of the funding for the mass health plans and services. Mass health cover is provided through the Mass Health Plan Assurance Fund (MPHIA). The fund was created to help stabilize the nursing home populations of Massachusetts. MassHAP, Mass Health Insurance Plan (MHO), and the Office of the Secretary of Health and Human Services, are the state agencies that manage the funds.
There are several steps involved in applying for Mass health cover. First, you must complete an application, called a Free Application for Health Insurance (FEIN). Filling out an application indicates that you meet certain income and family size requirements. Second, you must agree to accept the premium estimate from the insurance company. Third, once you’ve agreed to a premium estimate, you must complete and submit an enrollment agreement.
To be considered for mass health plan coverage, you must be at least 65 years of age, as well as meet the other general eligibility requirements. You must reside in Massachusetts and be eligible for Medicare. Your eligibility will be determined by the insurance plan you select, as well as the health care provider you choose. MassHAP offers special enrollment considerations for members of the military.
In order to qualify for Mass health cover, you must pay your first year’s premium on time. If you fail to pay your premium, you will be dropped from the plan. If you become a mass health plan member and find that you are not eligible for Medicare, you will need to register for enrollment with a commercial insurer. The commercial insurer will then provide coverage for the MassHAP programs, as well as for the services offered by the Massachusetts Health Plan Assurance Fund (GHPA).
Massachusetts is a premier state for home based businesses. Many of the nation’s most successful companies have begun operations here, including some of the world’s most prestigious brands. This high level of success is partly due to the excellent health care, education, and workforce development systems that are provided by the Mass Health Board. However, not all Massachusetts residents may qualify for mass health care coverage through the MassHAP programs. If you fall into one of the MassHAP eligibility categories, but you do not qualify for Medicaid because you are not currently receiving Medicaid or Medicare, or you are ineligible because you are on another type of health care program, MassHAP may be able to help you afford the coverage you need to secure your future. For more information on what kinds of circumstances will qualify you for MassHAP coverage in Massachusetts, and for specific guidelines for enrollment, you should contact a licensed insurance agent in your area.