See your Massachusetts health insurance coverage options.

To purchase health coverage through the Massachusetts Marketplace, you must:⁷

• Live in Massachusetts
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

Eligibility for premium subsidies and cost-sharing reductions through the Marketplace depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.

It’s important to note that Massachusetts is one of the states that has its own individual mandate, and residents who don’t have health insurance are subject to a penalty when they file their state tax returns.⁸  The individual mandate in Massachusetts pre-dates the ACA. It was paused from 2014 through 2018, when there was a federal penalty for not having health insurance. Massachusetts revived the state-based penalty in 2019.

The open enrollment period for individual/family health coverage in Massachusetts runs from November 1 to January 23. This is slightly longer than in most states.⁹ 

Outside of open enrollment, a qualifying life event is generally necessary to enroll in a plan or make coverage changes. But residents who are eligible for ConnectorCare can enroll anytime if they are newly eligible or haven’t previously enrolled.¹⁰

To enroll in an ACA Marketplace plan in Massachusetts, you can: 

• Visit the Health Connector to access Massachusetts’s state-run health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans. 
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.¹¹

The Massachusetts Health Connector debuted a program for automatic enrollment in 2022. It allows applicants to check a box on the application indicating that if they are eligible for a $0 premium ConnectorCare plan but don’t select a plan themselves, the exchange will automatically enroll them in a $0 premium plan. If the applicant had coverage in the past with a carrier that offers one of the available $0 premium plans, the exchange will enroll the person with that carrier. If not, and if multiple $0 premium plans are available, the exchange will randomly assign the person to one of the available plans. But applicants in this scenario have the option to select a different plan instead of the one to which they’re automatically assigned.¹²

The federal government reported that 1,568 people who previously had MassHealth coverage had been automatically enrolled into a qualified health plan by the Massachusetts Health Connector between April and June 2023.¹³

Residents in Massachusetts use the Health Connector to enroll in Marketplace health coverage as well as to determine subsidy eligibility. Both non-standardized and standardized health plans are available through the Health Connector.¹⁴

The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset premium payments to help keep your expenses down. More than 74% of Massachusetts Health Connector enrollees saved money on 2023 premiums. The average subsidy for these enrollees was $381/month, resulting in an average after-subsidy premium of $118/month.¹⁵

In addition to federal subsidies, Massachusetts residents may also qualify for ConnectorCare plans. ConnectorCare plans qualify for the federally funded ACA premium tax credits, but are also subsidized by the state, resulting in even lower premium and out-of-pocket costs for eligible residents.¹⁶

ConnectorCare has historically been available to applicants with income up to 300% of the poverty level. But starting in 2024 (applications can be submitted as of November 2023), ConnectorCare eligibility is expanding to 500% of the poverty level.¹⁷

In addition to premium subsidies, people with household incomes up to 250% of the federal poverty level also qualify for cost-sharing reductions (CSR). These subsidies reduce deductibles and other out-of-pocket expenses as long as the enrollee selects a Silver plan.[enf_note]”APTC and CSR Basics” Centers for Medicare and Medicaid Services. June 2023[/efn_note] Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.

Source: CMS.gov¹⁵

Eight insurers offer exchange plans in the Massachusetts exchange for 2023, and all eight will continue to offer coverage in 2024.¹⁸

• Boston Medical Center Health Plan/WellSense
• Fallon Community Health Plan
• Health New England (HNE)
• Mass General Brigham Health Plan (formerly AllWays Health Partners; formerly Neighborhood Health Plan)
• Tufts Health Plan Direct
• Blue Cross Blue Shield of Massachusetts (BCBSMA)
• Harvard Pilgrim Health Care (for 2023, this includes members who had Tufts Premier in 2022, as a result of a merger)
• UnitedHealthcare

There are also two insurers — HPIC Insurance Company and ConnectiCare of Massachusetts, Inc. — that only offer plans outside the exchange. However, their combined total enrollment in individual/family plans is fewer than 450 people.¹⁹

In most Massachusetts counties, there are at least five insurers offering 2023 Marketplace health plans.²⁰

The following average rate changes have been approved for 2024 for the insurers that offer coverage through Massachusetts Health Connector, amounting to an overall weighted average increase of 3.2%, before any subsidies are applied:¹⁹

Source: Office of Consumer Affairs and Business Regulation¹⁹

Because Massachusetts has a merged individual and small-group market, each carrier’s rate changes apply to both individual and small-group plans.

For perspective, here’s a summary of how average premiums have changed in Massachusetts over time:

• 2015: 1.6% increase²¹
• 2016: 6.3% increase²²
• 2017: 19% increase²³
• 2018: 18% increase²⁴
• 2019: 4.7% increase²⁵
• 2020: 5.2% increase²⁶
• 2021: 7.9% increase²⁷
• 2022: 6.9% increase²⁸
• 2023: 7.6% increase²⁹

During the 2023 open enrollment period, 224,934 people enrolled in a health plan through the Massachusetts exchange.¹⁵

The increased enrollment in recent years is likely due to the American Rescue Plan (ARP), which made millions of Americans newly eligible for premium subsidies.³⁰ These subsidy enhancements have been extended through 2025 by the Inflation Reduction Act.

Source: 2014,³¹ 2015,³² 2016,³³ 2017,³⁴ 2018,³⁵ 2019,³⁶ 2020,³⁷ 2021,³⁸ 2022,³⁹ 2023³⁰

Massachusetts Health Connector
877-MA-ENROLL (877-623-6765)

State Exchange Profile: Massachusetts
The Henry J. Kaiser Family Foundation overview of Massachusetts’s progress toward creating a state health insurance exchange.

Health Care for All – Massachusetts Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.(800) 272-4232

Office of Patient Protection, Department of Public Health
800-436-7757 (toll-free nationwide)
Serves residents and other consumers who receive health coverage from a Massachusetts carrier, insurer, or HMO.