You can see the co-pays for different services in the chart on the next page. All of the plans offered for each Plan Type will have the same benefits and co-pays for covered services. There are different ConnectorCare Plan Types, which are based on your income. ConnectorCare plans have low monthly premiums, low co-pays, and no deductibles. What kind of coverage do you get with ConnectorCare?ĬonnectorCare plans offer great coverage with important benefits like doctor visits, prescription medications, and emergency care. The table below summarizes the subsidies provided by CCA during the audit period.ConnectorCare Plans: Affordable, high-quality coverage from the Health ConnectorĬonnectorCare plans have $0 or low monthly premiums, low out-of-pocket costs, and no deductibles. For example, a married couple living in Boston with a combined household income of $50,000 would qualify for a monthly tax credit of $75 to help reduce their monthly premium. This subsidy is applied to a member’s monthly health insurance premium to further reduce it to an amount the state finds acceptable given the member’s income level. These subsidies are calculated and applied by CCA.Ī state wrap is a subsidy based on an annual affordability schedule that corresponds to federal poverty levels. The federal and state governments may be reimbursed at the end of the year if actual expenditures were less than what was advanced to the carriers. A member would receive a tax refund if s/he overestimated his/her projected annual household income.įederal and state CSRs are subsidies designed to lower an individual’s out-of-pocket costs and are advanced throughout the year to the insurance carriers operating in Massachusetts. When a member files his/her federal income tax return, the member may be required to pay the excess APTC used if his/her actual annual household income exceeded the projected annual income, since the applied APTC would have been higher than what s/he was entitled to receive. 1 The amount of the APTC is calculated by CCA based on a member’s projected annual household income and is applied by CCA to the member’s monthly insurance premium. The APTC is available to applicants with household incomes at or below 400% of the federal poverty level. Residents are ineligible for financial assistance if they can obtain coverage through Medicare or Medicaid, are currently in jail, or are offered affordable health insurance through their employers.įinancial assistance is provided in the form of the federal Advance Premium Tax Credit (APTC) and through other subsidies, including federal and state cost-sharing reductions (CSRs) and a state subsidy known as a state wrap. Massachusetts residents can receive financial assistance to pay for healthcare if they are United States citizens or can verify that their presence in the United States is lawful and they meet the applicable income eligibility requirements. Advance Premium Tax Credits and Subsidies CCA uses the same regulations as MassHealth, Title 130 of the Code of Massachusetts Regulations, in determining whether an applicant is eligible to participate in the program and verifying information provided by applicants.Īccording to its website, CCA offers insurance from 13 health and dental providers: Altus Dental, Ambetter from CeltiCare Health, Blue Cross Blue Shield of Massachusetts, Boston Medical Center HealthNet Plan, Delta Dental, Dental Blue, Fallon Health, Guardian Dental, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan, Minuteman Health, and Tufts Health Plan.ĬCA is governed by an 11-member board that includes the Secretary of the Executive Office of Health and Human Services, who is the chair the Secretary for Administration and Finance the Commissioner of Insurance the executive director of the Group Insurance Commission four members appointed by the Governor and three members appointed by the Attorney General. Massachusetts residents apply for health insurance through CCA by first submitting an application that requires information such as applicant name, Social Security number, date of birth, household income, family size, and place of residence.
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