Health Coverage Programs for Which You May be Eligible
For assistance in enrolling in any of these programs please call us at 663-8711. We will help you complete the applications and help you through the enrollment process.
Qualified Health Plans
Qualified Health Plans are health plans that offer all required benefits specified under national health reform. They are offered by private health insurance companies and are sold through the Massachusetts Health Connector. Individuals with incomes up to 400% of the federal poverty guidelines, $48,240, or $98,400 for a family of four, may be eligible for advanced premium tax credits, that's money the federal government pays directly to insurance companies every month so that individuals have lower monthly premiums.
ConnectorCare plans are qualified health plans for individuals and families with incomes up 300% of the federal poverty guidelines, $36,180 for an individual, or $73,800 for a family of four. In addition to premium tax credits, individuals and families will also receive help paying paying out-of-pocket costs for health care.
There are a number of new programs now for low to moderate income individuals and families in Massachusetts. Some families who currently have insurance now may be eligible to have the cost of their insurance premiums reduced by the Commonwealth.
Health Safety Net
Residents in Massachusetts are eligible for free care at acute care hospitals and community health centers in Massachusetts if they fall within income guidelines and they are not eligible for other public health programs, or if they have access to employer-sponsored heath insurance that is considered affordable. If one’s income is above these guidelines one may be eligible for reduced fee care. Please contact us for current income guidelines and regulations.
The Children’s Medical Security Plan
This is available to any child 18 and under in Massachusetts who is over income guidelines for MassHealth. It is essentially a program that covers outpatient services, $700 of dental care and $200 of medications. Of importance, any child in Massachusetts not eligible for MassHealth is eligible for the Children’s Medical Security Plan.
Medicare Part-D Drug Plan
Since January 1, 2006 all recipients of Medicare have been able to receive prescription drug coverage under Medicare. Prescription drug plans will be offered by private companies. Medicare recipients will pay a monthly premium and pay a share of the cost of prescriptions, costs will vary depending on which drug plan the recipeint chooses.
Some people with limited resources and income are eligible for Extra Help to pay for the costs—monthly premiums, annual deductibles, and prescription co–payments—related to a Medicare prescription drug plan. To qualify for Extra Help:
Your resources must be limited to $13,820 for an individual or $27,600 for a married couple living together. Resources include such things as bank accounts, stocks, and bonds. Your house does not count your house and car as resources; and
Your annual income must be limited to $18,336 for an individual or $24,600 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where your income may be higher are if you or your spouse:
Support other family members who live with you;
Have earnings from work
The Prescription Advantage Plan
Prescription Advantage offers drug coverage support to Massachusetts residents 65 and over, and to disabled individuals under age 65 who fall under certain income guidelines. For residents who have Medicare, Prescription Advantage may be able to help decrease the cost of your Medicare prescription drug coverage. Depending on your income and the Medicare Prescription drug coverage you have chosen, Prescription Advantage may help pay all or part of your deductibles, and co-payments.
Medicare Premium Assistance
Called the MassHealth Buy-In Program, this helps income and asset-eligible Medicare beneficiaries pay their monthly Medicare premiums.
The SHINE PROGRAM (Serving Health Information Needs of Everyone) offers free information, counseling and assistance to help Medicare beneficiaries understand benefits, billing, claims, appeals and all available insurance options.