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How Massachusetts Realtors Should Compare Health Insurance Plans
Agents compare premiums and stop. Here's the order that actually protects you.
1. Out-of-pocket maximum
The most you can spend in a year on covered care. This is the number that matters in a bad year. Marketplace plans in Massachusetts cap around $9,200 individual; private PPOs commonly $6,000–$9,000.
2. Network — and where it works
Is your doctor in it? Is the hospital you'd actually go to in Suffolk County in it? Does it work in another state? HMO vs. PPO decides this. Cigna, Aetna and PHCS PPO PPOs are national.
3. Deductible
How much you pay before the plan pays. Healthy agents usually do best with a mid-range deductible and lower premium, plus an HSA.
4. Premium
Only now. And compare net of subsidy if you qualify, net of the self-employed deduction either way. Massachusetts has a flat 5% state income tax, so the self-employed health premium deduction helps at both the federal and state level.
5. Enrollment flexibility
Marketplace: once a year. Private: any month. If your income is volatile, flexibility has value.
Massachusetts is one of the most tightly regulated individual markets in the country: the state mandate requires coverage that meets minimum creditable coverage rules, and many non-ACA plans don't. Private options here are narrower than in most states, so the honest answer is usually a careful comparison, not a promise of savings.
Our quoting tool shows every private plan in Massachusetts with deductible and out-of-pocket max side by side. Or check your options and we'll compare both markets for you.