Health Insurance

Headline:

The CDC recently authorized COVID-19 vaccines for children under 5, meaning that all MA residents older than 6 months are eligible to receive the free COVID-19 vaccine.

Last-reviewed: 9am, June 23, 2022

Key Resources:

The Basics:

  • 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.
  • During the national Public Health Emergency, MassHealth can only be terminated or reduced in very limited circumstances. 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).

The Breakdown:

  • 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.
  • If the national Public Health Emergency ends as scheduled on July 15, 2022, people who no longer qualify for MassHealth may have their benefits terminated as early as August 1, 2022. These individuals may benefit from making appointments and refilling prescriptions before their coverage is terminated or reduced.  
  • 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 all 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.
  • Find additional information on COVID-19 vaccines and boosters on the COVID-19 Vaccine and Booster Information page.
  • COVID-19 tests sites are available throughout the state. In addition, some people may be eligible for testing at no cost. 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.
  • Households can complete a form on covidtests.gov to get another round of 8 free COVID-19 tests shipped to their home.
  • MA is distributing another 2 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.
  • 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.
  • 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.

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, boosters, testing, and treatment are available throughout the Commonwealth.