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PPO Health Insurance in Massachusetts for the Self-Employed: Where to Find It
Ask for a PPO on the Massachusetts Health Connector in Massachusetts and you'll mostly find HMOs and EPOs. Here's why, and where PPOs still live.
Why marketplace PPOs vanished
Guaranteed-issue plans attract the highest-cost members, and broad PPO networks are expensive to run for that population. Carriers like Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim, Tufts Health Plan, Mass General Brigham Health Plan, and WellSense responded by narrowing networks and dropping out-of-network benefits. The result: most individual plans in Massachusetts are built around one hospital system.
Where PPOs still exist
In the private shared-network market. Carriers lease the national Cigna, Aetna and PHCS PPO PPO networks — the same networks large employers use — and sell underwritten plans on them. No referrals, any in-network specialist, coverage in every state. For self-employed people who travel or want to choose their own doctors, this is usually the only way to get a PPO.
What a Massachusetts PPO costs
For healthy individuals, roughly $290–$600 a month depending on age and deductible; families roughly $800–$1,300. You can see live prices on our quoter.
Who qualifies
These plans are underwritten. Generally healthy applicants with no major pre-existing conditions. If that's not you, a marketplace plan is the right answer and we'll say so. 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.
Check your options to see the PPOs available in your ZIP.