Health Insurance for Massachusetts

Massachusetts is the only state in the country to make health insurance a legal requirement. After the health care reform bill was passed in 2006, residents were required to obtain health insurance or face penalties in the form of monthly fines. As a result, in December 2010, more than 98 percent of adults and 99.8 percent of children in Massachusetts are covered by health insurance plans.

History

• On April 4, 2006, the Massachusetts Legislature passed a law requiring all residents 18 years or older to purchase health insurance. The law stipulates that anyone who fails to obtain health insurance will face legal penalties.

Requirements

• To qualify as valid health insurance, the plan must meet the minimum creditable coverage stipulations. As of December 2010, to meet these minimums, the health insurance plan must cover a range of services, including diagnostic imaging and screening procedures, emergency services, hospitalization, maternity and newborn care, medical and surgical care, mental health and substance abuse services, prescription drugs, radiation and chemotherapy, and preventive care (with no deductible). Coverage with Medicare Part A, any Commonwealth Care Plan, any Commonwealth Choice plan, MassHealth (excluding MassHealth Limited), a student health insurance plan, a tribal or Indian health service plan, TRICARE, the U.S. Veterans Administration health system plan, or coverage under the Peace Corps, VISTA, AmeriCorps or the National Civilian Community Corps automatically meets the minimum coverage requirements.

Penalties

• The penalties for not purchasing health insurance vary by income and age. In 2010, the penalty for residents aged 18 through 26 who earned 300 percent or more above the federal poverty guidelines was a fine of $66 per month, or $792 per year. The fine for those over 27 years of age with an income above 300 percent of the federal poverty guidelines was $93 per month, or $1,116 per year.

Health Connector

• Residents of Massachusetts may use a website called the Health Connector (see Resources) to find a health insurance plan. The website assists residents in comparing plans and finding one that fits within their budget. For residents who meet certain income requirements, the Commonwealth Care plan is available at low or no cost.