MA Health Insurance

June 9, 2009 3:16 AM

Anyone know about Massachusetts Health Insurance? I'm between a rock and a hard place. I'm about to move to MA from overseas. I sent off application for the low-cost insurance, Commonwealth Care, but it may be weeks after I arrive to hear whether I qualified.

I do not want to go one minute without coverage in the U.S. so I thought I'd get a short-term policy. However, as I understand it, if you have any prior health insurance at all in the U.S., including short-term, you can't qualify for the Commonwealth Choice low-cost option. The other available insurance, a high deductible polict or Health Savings account is $500 a month. Any advice on how to proceed? Based on fruitless calls to MA Insurance Dept. it seems to be a Catch 22 situation unless I'm missing something. Any advice?

posted by Elsie to health & fitness (10 comments total)

if you have any prior health insurance at all in the U.S., including short-term, you can't qualify for the Commonwealth Choice low-cost option

If by this you mean "if you have previously had any health insurance at all in the U.S." then I can assure you that this is NOT true.
posted by Rock Steady at 3:55 AM on June 9

i don't know, but a pretty good source for MA healthcare is healthcareforartists.org.

good luck.
posted by rmd1023 at 4:29 AM on June 9

I switched over to Commonwealth Care (the low-cost option, which is income dependent) for the year between undergraduate and graduate school, which I am just now finishing up. I applied for Commonwealth Care 2 months before my university-sponsored insurance ran out. I just indicated that I wasn't covered any more, and asked for my Commonwealth Care coverage to start on the day my university-sponsored coverage ran out. There was no problem and my application was approved and processed in about 3 weeks. Since Massachusetts has a LAW that you must be covered by health insurance at all times (there's quite a fine if you are not), they are fairly understanding about whatever hoops you need to jump through to ensure that you are covered.

So, I guess I would suggest getting temporary insurance, like travel insurance, and paying for, say, 2 months of it. When you get here, apply for Commonwealth Care right away, and just indicate that you want it to start when your temporary insurance runs out. If my experience is indicative, that'll work, and if they somehow find out you already have insurance, you can explain that it's only for another month and you just don't want to pay the MA fine for being uninsured.

I've actually been incredibly impressed with Commonwealth Care - I've found it to be well organized, I have a great doctor who is affiliated with a great medical school, and I pay absolutely nothing. YAY for socialized medicine.
posted by Cygnet at 5:02 AM on June 9 [1 favorite]

YAY for socialized medicine. The Commonwealth of MA is forcing you to buy insurance or pay a hefty fine. This is far from socialized medicine...

I don't know what you can afford, but Blue Cross of MA has plans starting at $238.00/ month. Also try http://www.givemeinsurancequotes.com/gmiq/healthinsurance.php?PHPSESSID=1af4ff77d52f3cc73f97965b15005a3b
posted by Gungho at 6:13 AM on June 9

Apologies if you've already tried this, but the state has an insurance portal at http://www.mahealthconnector.org/portal/site/connector/ that may be able to help.

It's also worth noting that the fine is only assessed when you file state taxes, is proportional to the number of months you are without insurance, and, at least in 2008, you could go without insurance for 3 months without penalty. There are also exemptions based on income. Not that I'd recommend going without insurance.
posted by bitterpants at 6:43 AM on June 9

There's also the MA Health Connector which explains all your options. It's a site set up by the state to facilitate comparisons between plans and finding the right plans for you. I used it last year when I needed some coverage. I would start there, since it's an unbiased source.
posted by reddot at 6:52 AM on June 9

My daughter is simultaneously insured by my company's carrier as well as MassHealth, so absolutely you can have prior and current coverage.
posted by plinth at 7:06 AM on June 9

I'm on Commonwealth Care, and if I lived in any other state I probably would have to go without insurance because I couldn't afford it. Apply for Commonwealth Care, and even though it will take a while for it to get approved and for you to get your card, you are covered on a minimal basis as soon as you apply—they'll explain the details to you. It's a good system and I wish the rest of the country would get on board.
posted by languagehat at 9:05 AM on June 9

Elsie, as I recall a while back you were inquiring about Medicare plans. One important thing to know is that you won't qualify for Commonwealth Care if you're eligible for Medicare because of age or disability--Medicare itself is much better insurance than anything the state could give you. If you have a low income, the state can help pay your Part B premiums and copays for Medicare, though.

If your previous question was for someone else, and you don't qualify for Medicare, then you have three major avenues for getting insurance in Massachusetts:

*If you're very low income and fall into certain eligibility categories (for instance, over age 65, under age 19, disabled, or a parent/caretaker of a minor child), then you're probably eligible for MassHealth. This is very comprehensive insurance and you'll generally pay nothing out of pocket. It's not very easy to qualify for, though--you must be very low income.

*If you're low- to moderate-income--generally below 300% of the federal poverty level, which varies depending on how big your household is--but don't fall into any of the above categories (for instance, if you are a nondisabled adult without minor children), then you might be eligible for Commonwealth Care. However the state does require that you be currently uninsured and not have been offered insurance through your employer within the last 6 months. So you wouldn't want to sign up for a temporary plan before coming to Massachusetts if you think you qualify for Commonwealth Care.

*Anybody who is a resident of Massachusetts can sign up for a health plan through Commonwealth Choice. Every health insurance carrier that offers a plan through Commonwealth Choice has to sell you a policy if you apply--they can't turn you down. There are also limits on how much they can charge you; basically, they have to charge everyone in the same geographic area (like Boston) and in the same age group the same premiums. You can find how much insurance would cost you through the website above--they classify plans as "bronze" (lowest-cost), "silver" and "gold" (highest-cost), but all of them are comprehensive insurance that cover things like prescription drugs, doctors visits, and hospital care. You should be able to find one that isn't a high-deductible plan, although the premium may be a bit more expensive. (For example, it looks like a 60-year-old living in Boston would pay between $450-550 per month for the "bronze" level of insurance.)

It sounds like you might be best off if you go and sign up for Commonwealth Care as soon as you move to Massachusetts. Realistically, the chances that you'll have a high-cost medical event in the first few weeks of moving the the state seem pretty low. Since health insurance plans can't reject you for being sick or in the middle of an expensive medical event, even if something did happen you'd still be able to sign up for insurance starting the next month (and maybe sooner). When people talk about how very important it is to not have a gap in health insurance, it's because health insurance companies can usually exclude any condition that occurred while you were uninsured. These exclusions are not legal in Massachusetts, so in my opinion you really shouldn't worry too much about going a few weeks without insurance. (Unless you have a current medical condition that you know is likely to require expensive care right when you move back.)
posted by iminurmefi at 2:56 PM on June 9 [1 favorite]

I've been in MA for the past year - it took two weeks for me to hear back from Commonwealth Care and select a policy based on my income. You can go to the Commonwealth Connector website to download the application form. The part that took me the longest is that you have to submit two paystubs to prove your income level. After that, you're eligible to choose a plan based on said income level.

Or basically, what iminurmefi said. Except that I added the nice little tidbit about the paystubs.
posted by grapefruitmoon at 5:19 PM on June 9