High Deductible Insurance Plans in Massachusetts

Health insurance is mandatory in Massachusetts for all residents 18 years of age or older. According to state insurance regulations, health insurance must provide certain types of coverage. High-deductible health plans (HDHP) meet mandatory coverage requirements for Massachusetts. High-deductible insurance covers medical expenses only after the deductible has been met. HDHP plan members must pay all or part of their medical bill until they reach the annual deductible.

Aetna Health Fund

• Aetna Health Fund HDHP with HSA is a high-deductible insurance plan in Massachusetts. This plan combines insurance coverage with a health savings account to help those insured pay down the deductible or use the savings for other health care expenses. The plan provides 100-percent coverage for preventative care such as wellness screenings and exams as long as plan recipients use health professionals within the PPO network.

  The in-network deductible is $1,500 and the out-of-network deductible is $2,500 for a single person. For a family, the in-network deductible is $3,000 and the out-of-network deductible is $5,000. This plan also has a co-insurance provision, which refers to what percentage of the cost of medical services the plan will pay after the deductible has been met. In-network co-insurance is 90 percent. Out-of-network co-insurance is 70 percent of the cost of services.

Fallon Community Health Plan

• Fallon Community Health Plan offers several high-deductible health insurance plans in Massachusetts. Participants can purchase an HDHP along with a health savings account if desired. Fallon Community plans have deductibles that range from $1,250 to $2,000 for individuals to $2,500 to $4,000 for families.

  The FCHP Select Care Choice 1250 plan is a health maintenance organization (HMO) high-deductible plan that gives Massachusetts residents access to a network of health care providers and community-based hospitals across the state. This plan has $0 co-pay for primary care visits, physical exams and gynecological exams. The plan also offers fitness reimbursement for members who join a local gym, participate in yoga and/or join Weight Watchers.

Harvard Pilgrim Health Care

• Harvard Pilgrim Health Care offers Massachusetts residents a high-deductible health plan called the Best Buy HSA PPO. The plan covers services such as diagnostic testing, surgery procedures, outpatient mental health care and routine physical exams. Prescription drug coverage is also available. Most services are subject to an in-network or out-of-network annual deductible. A co-insurance applies for most out-of-network services.

  The Best Buy HSA PPO is not a health savings account, but does allow plan participants to contribute to an HSA to help pay for medical expenses. Plan participants can make tax-free contributions of up to $3,050 for an individual and up to $6,150 for a family.

Celticare Health Plan

• Celticare Health Plan of Massachusetts offers a high-deductible plan called the Celticare Saver 2000. The Celticare plan helps pay hospital costs as well as expenses for medically necessary services. The plan is an HMO and covers physical exams, vision exams, emergency room visits, X-rays, lab tests, and inpatient and outpatient surgeries. Prescription drug coverage is available after a $250 prescription drug deductible is met for an individual. Families must meet a $500 prescription drug deductible.