Home › Blog › Overpaying for Health Insurance in Massachusetts? Here's What You Can Do
Overpaying for Health Insurance in Massachusetts? Here's What You Can Do
If your premium went up again and your coverage didn't, you're not imagining it. Here's the checklist we walk clients through.
Are you getting a subsidy you qualify for?
A surprising number of self-employed Massachusetts residents buy full-price plans directly from a carrier and never apply through the Massachusetts Health Connector. If your income is under the 400% line, you're leaving money on the table.
Are you paying full price while healthy?
If you're above the subsidy line and in good health, you're paying a guaranteed-issue price for a risk you don't represent. Private shared-network PPOs on Cigna, Aetna and PHCS PPO price on health and are routinely hundreds less per month.
Is your network the one you use?
Many Massachusetts marketplace plans are HMOs centered on one hospital system. If you drive past in-network hospitals to reach your doctor, or travel, you're paying for a network you can't use. A national PPO fixes that.
Is your deductible matched to your usage?
Healthy people on low-deductible plans overpay every month for a deductible they never reach. Moving to a mid-deductible plan plus an HSA is often the right trade.
Massachusetts specifics
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. Massachusetts has its own individual mandate: adults must carry coverage that meets the state's minimum creditable coverage standard or owe a penalty on their state return.
We do this review free, in 15 minutes, for anyone in Massachusetts. Check your options.