Health Insurance

Headline:

Many residents who buy their health insurance through the Massachusetts Health Connector will face rising premiums, paying an average of 7.6 percent more in 2023.

Last-reviewed: 9am, Oct. 6, 2022

Key Resources:

The Basics:

  • Thousands of Massachusetts residents who buy their health insurance through the Health Connector will face rising premiums, paying an average of 7.6 percent more in 2023.
  • All people ages 6 months and older are encouraged to get the COVID-19 vaccine if they live, work, or study in MA. Boosters are recommended for everyone ages 5 and older. Find additional information on mass.gov.
  • The CDC recommends updated Moderna and Pfizer COVID-19 boosters, which are now available in Massachusetts.
  • During the national COVID Public Health Emergency (PHE), MassHealth can only be terminated or reduced in very limited circumstances. The PHE was recently extended through October 13, 2022, and is expected to be extended again into 2023. See the full guidance for details.
  • MassHealth Enrollment Centers are open for limited walk-in appointments. To set up an in-person appointment to discuss a health plan, use the appointment scheduler or call Customer Service (800-841-2900).
  • Although the US Supreme Court has overturned Roe v. Wade, eliminating the constitutional right to an abortion, abortion remains legal in Massachusetts.
  • Governor Baker recently signed legislation to further protect access to reproductive health care services in Massachusetts.
  • Fourteen clinics are offering the monkeypox vaccine to people who live or work in Massachusetts and meet the CDC’s eligibility criteria. Find more information here.
  • The FDA has approved over-the-counter hearing aids, making them more affordable and available to purchase this fall without a hearing exam, prescription or fitting appointment.
  • The CDC’s latest COVID-19 guidance for healthcare workers – including those in nursing homes and home health settings – loosens masking requirements unless community transmission levels are high.

The Breakdown:

  • On August 4, 2022, the White House declared the spread of monkeypox a Public Health Emergency, and MA has begun offering vaccinations to curb the spread of monkeypox. Fourteen clinics are offering the vaccine to people who live or work in Massachusetts and meet the CDC’s eligibility criteria. Find more information here.
  • The No Surprises Law requires many healthcare providers to give patients an up-front cost estimate of services. If the patient is later charged more than $400 above that estimate, they have an opportunity to file a dispute. There are also new limitations to out-of-network charges for some insured patients. For additional information, see the CMS consumer overview.
  • The federal COVID public health emergency (PHE) is currently in effect through October 13, 2022. The PHE is expected to be extended further into 2023. While the PHE is in effect, continuous Medicaid coverage must be provided to enrollees.
  • As early as August 1, 2022, MassHealth will begin recertifying all members. Information will be sent by mail. Members can prepare by ensuring that MassHealth and SSA have their correct mailing address on file.
  • MassHealth covers testing and treatment for COVID-19 as well as the COVID-19 vaccine and booster at no cost to members.
  • COVID-19 vaccines are available for people ages 6 months and older. Find a vaccine distribution location online or by calling Mass 2-1-1. COVID-19 boosters are available for people ages 5 and older and who received their vaccination(s) from Pfizer or Moderna at least 5 months ago or from Johnson & Johnson at least 2 months ago.  On September 1, 2022, the CDC approved updated boosters, which are now available in Massachusetts.
  • Find additional information on COVID-19 vaccines and boosters on the COVID-19 Vaccine and Booster Information page.
  • COVID-19 test sites are available throughout the state. For additional information, visit the Find a COVID-19 Test page.
  • Most insurers are required to cover 8 at-home COVID-19 tests per month. Insurers can choose to have people pay up-front for tests and submit their receipt with a claim for reimbursement of up to $12.00 per test. For additional information, read the full HHS announcement. Individuals should also check with their healthcare insurer for details. 
  • Free COVID-19 tests are available for MA residents who live or work in congregate care, have symptoms of COVID-19, or had recent contact with someone who tested positive for COVID-19. Individuals seeking a free at-home test should check the  Labcorp website daily as availability is limited.
  • MA is distributing another 5 million free COVID-19 testing kits to towns and cities across the state. Check here for a list of cities and towns that will have the rapid tests. 
  • MassHealth and Health Safety Net members may qualify for curb-to-curb transportation to vaccine, booster, and testing appointments. Members should ask their doctor to submit a transportation request (i.e., a “PT-1 form”). If they have difficulty with the process, they can also call 1-800-841-2900.
  • MassHealth covers some commonly used over-the-counter medications without prior authorization (e.g., aspirin, hydrogen peroxide, vitamin supplements). See the full list for details.
  • Thousands of Massachusetts residents who buy their health insurance through the Health Connector will face rising premiums, paying an average of 7.6 percent more in 2023. Learn more here.
  • For assistance navigating health insurance enrollment, getting medications or care covered, or finding affordable options, call the Health Care For All (HCFA) HelpLine at 800-272-4232 or submit an inquiry online. Assistance is available in English, Spanish, and Portuguese. Health Care For All’s Boston office has re-opened for in-person assistance.
  • If you have a problem with health insurance claims or medical bills, the Attorney General’s Health Care Division may be able to help. Call the helpline with questions or complaints at (888) 830-6277.
  • Veterans may be eligible for healthcare services through the VA. Use the VA website to navigate eligibility, benefits, and find providers. Those who received a less than honorable discharge can also use this Veteran’s Legal Services Guide.
  • On June 24, 2022, the Supreme Court overturned Roe v. Wade, holding that there is no federal constitutional right to an abortion. As a result of the decision, abortion rights will now be determined by the states with 26 states certain or likely to ban abortion. Abortion is still legal in Massachusetts. To see the effects of the SCOTUS decision on abortion laws and restrictions in specific states, check here.
  • On July 29, 2022, Governor Baker signed legislation to further protect access to reproductive health care services in Massachusetts. The law codifies several protections that Governor Baker put in place by Executive Order in June.
  • President Biden has signed two Executive Orders to protect women’s access to reproductive healthcare services. Read more on the new official government website reproductiverights.gov.
  • The FDA has finalized a rule to approve over-the-counter hearing aids, making them less expensive and available to purchase online and in stores as soon as this fall. Consumers will not need a medical exam, prescription or adjustment by an audiologist for this new category of hearing aid. Read the FDA news release here.

The Bottom Line:

  • Eligible individuals and families can enroll in free or reduced cost health and dental insurance.
  • COVID-19 vaccinations for anyone over 6 months of age, updated boosters, testing, and treatment are available throughout the Commonwealth.
  • Even though the Supreme Court overturned Roe v. Wade, people still have access to safe and legal abortion in Massachusetts.