- Division of Insurance
Since March of 2020, the Families First Coronavirus Response Act allowed Medicaid recipients to retain their health coverage during the COVID-19 pandemic, regardless of eligibility. As the federal government has ended the public health emergency and Medicaid redetermination resumes, the Massachusetts Division of Insurance wants those residents who may no longer meet the requirements for MassHealth and need alternative health insurance coverage to know their options.
Employer-Sponsored Plan: If your employer offers health insurance, check with them to see if you are eligible for their health plan.
Individual Market: If you do not have access to an employer-sponsored plan, you have two ways to purchase a health plan.
- Through the Massachusetts Health Connector by visiting their website www.MAhealthconnector.org, or by calling 1-877-MA-ENROLL.; or
- Directly from a licensed insurance company. There are nine (9) licensed insurance carriers approved to sell insured health plans to Massachusetts-residents. A list can be found here.
It is especially important if you have to change your health coverage to be sure you are purchasing a comprehensive health insurance plan from an insurance company that is licensed to sell insurance in Massachusetts. Be careful when looking at websites when you are trying to learn about comprehensive health coverage available. Websites, including MassHealthPlans.com, Massachusetts-healthplans.com, and websites that reference “ObamaCare or ACA plans” may look like the state’s exchange but are not. These websites connect consumers with individuals, who may or may not be licensed insurance agents, in order to help sell other types of insurance or wellness plans, such as hospital indemnity insurance, limited benefit health plans, discount health plans, or health care sharing ministries. While these plans may be less expensive, they are not comprehensive health insurance and you risk facing significant medical bills in the event care is needed.
The Massachusetts Health Connector can only be accessed by visiting www.MAhealthconnector.org. The Health Connector may also be able to assist you with paying for your health insurance.
Keep in mind that you might not have the same access to doctors and medications that you had under your MassHealth plan. You can check a plan’s provider directory online to confirm whether your doctor and any specialists are in-network. The Division of Insurance requires insurance companies to keep up to date provider listings on their websites. You can also ask a prospective company about their drug formulary to see whether your prescription medications are covered.
The Division of Insurance does not oversee MassHealth and is not involved in redeterminations. To learn more about Medicaid redetermination, visit MassHealth’s website: MassHealth Eligibility Redeterminations | Mass.gov.
Only if you are informed by MassHealth that you are no longer eligible for a MassHealth plan should you contact the DOI with questions or concerns about purchasing health insurance or the legitimacy of a health insurance plan or company. To contact the Division’s Consumer Services Unit please call (617) 521-7794 or by email at CSSComplaints@mass.gov.
