The Cheapest Massachusetts Health Insurance for Individuals and Families
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Typically, you can get health insurance from your employer or government programs such as Medicaid or Medicare. However, if none of these options are available to you, you’ll have to purchase one from the Massachusetts insurance marketplace.
Keep in mind that the less expensive the cost of your health insurance plan in Massachusetts, the more you’ll have to pay for medical coverage. Plans with lower premiums typically have higher deductibles and out-of-pocket maximums.
MoneyGeek analyzed several private policies to help you find the best health insurance in Massachusetts for your unique needs. This study includes insurance from different tiers for buyers of different ages on the Massachusetts insurance marketplace.
The Cheapest Health Insurance in Massachusetts by Metal Tier
The Massachusetts insurance exchange divides private plans into four metal tiers, including Bronze, Silver, Gold and Platinum. Though these do not affect the quality of care you receive, they determine the percentage of your medical expenses to be covered. Lower level plans, such as Bronze ones, cost less each month but may require you to pay more out-of-pocket if you need medical care.
The cost of health insurance policies in Massachusetts within a metal tier vary, but on average, their monthly premiums are:
- Bronze: $403 per month
- Silver: $533 per month
- Gold: $634 per month
- Platinum: $843 per month
Tiers named after more valuable metals, like gold or platinum, require you to pay a higher monthly premium. If you have a lot of medical expenses, this may turn out to be more cost-effective since you’ll pay less out of pocket.
In the Massachusetts insurance exchange, policy premiums, out-of-pocket maxes and deductibles vary within tiers. The table below reflects the cheapest health insurance in Massachusetts for each metal tier using monthly premiums.
If you earn less income, check if you’re eligible for cost-sharing reductions (CSR). These are available for those who purchase Silver plans and cause your deductibles to be lower than usual, making them an excellent deal.
These are plans for a 40-year-old male buyer for EPO and HMO plans. Of these, HMOs are most common in Massachusetts.
Cheapest Health Insurance in Massachusetts by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- BronzeStandard High Bronze HSA: BMC HealthNet Plan BronzeBMC HealthNet Plan$272$7,000
- SilverStandard Silver: BMC HealthNet Plan Silver A IIBMC HealthNet Plan$367$8,550
- GoldNon-Standard Low Gold: BMC HealthNet Plan Low GoldBMC HealthNet Plan$410$5,800
- PlatinumStandard Platinum: BMC HealthNet Plan PlatinumBMC HealthNet Plan$538$3,000
The Cheapest Health Insurance in Massachusetts by Age and Metal Tier
Health insurance providers consider several factors when setting policy premiums. Your age when you purchase a plan has an impact on the cost of health insurance in Massachusetts. This applies to all types of plans available in the state, including HMOs and EPOs. For example, a 26-year old buyer pays an average of $452 per month for a Silver HMO plan. In comparison, a 60-year-old buyer purchases a similar policy for double the price, with monthly premiums costing an average of $904.
Health Insurance Costs in Massachusetts by Age and Metal Tier
The cost of health insurance in Massachusetts shown is based on policies using sample ages only. These rates don’t consider your unique combination of age and income. Older buyers may find cheaper plans in the marketplace as they may be eligible for tax premiums and other regulations that lower costs. If you want to get an exact quote, you’ll have to apply for a plan.
You can use the table below to switch between metal tiers and buyer ages. To give you a better understanding of health insurance in Massachusetts, you can read MoneyGeek’s guide on the various metal tiers. These may help you figure out which level best suits your medical requirements.
Cheapest Health Insurance in Massachusetts by Age And Metal Tier
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- PlanCompanyMonthly Rate
- BronzeHMOBMC HealthNet Plan$147
- BronzeHMOTufts Health Plan Direct$156
- BronzeHMOTufts Health Plan Direct$157
- BronzeHMOHealth New England$161
- BronzeHMOHealth New England$171
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The Cheapest Health Insurance in Massachusetts by County
Another factor that impacts the cost of health insurance in Massachusetts is the area in which you live. In Massachusetts, similar to other states, insurance providers use rating areas to calculate policy premiums. Rates are computed the same way for counties within each rating area.
Massachusetts has fourteen counties divided into seven rating areas. In Middlesex, its most populous county of the 14 counties in the state, the cheapest Silver plan is Standard Silver: BMC HealthNet Plan Silver A II by BMC HealthNet Plan. It costs $354 per month.
If you want to find the most affordable health insurance plan in Massachusetts for all metal tiers in your county, use the table below.
Cheapest Health Insurance Plans in Massachusetts by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- $10BronzeTufts Health Plan DirectNon-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance$293
- $11BronzeTufts Health Plan DirectNon-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance$293
- $12BronzeTufts Health Plan DirectNon-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance$293
- $13BronzeTufts Health Plan DirectNon-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance$293
- $14BronzeHealth New EnglandNon-Standard Bronze: HNE Thrive Bronze$274
The Cheapest Health Insurance in Massachusetts With High Out-of-Pocket Maxes
Being young isn’t a reason to not get health coverage. If you think you may not need a lot of medical care, purchasing a low-cost plan with a high out-of-pocket maximum could be an option. It ensures that you have health insurance while costing you a small amount per month. The trade-off is you’ll have to spend more out of pocket if you have a medical emergency or your visits to the doctor increase in a given year.
Comparing private plans with out-of-pocket maximums of $8,250 and above, MoneyGeek found that the cheapest health insurance in Massachusetts for a 26-year-old buyer is Non-Standard Bronze: Tufts Health Direct Bronze 3550 with Coinsurance from Tufts Health Plan Direct. Its premium costs an average of $274 per month.
Tufts Health Plan Direct
Tufts Health Plan Direct offers the cheapest Bronze health insurance plan in Massachusetts for policies with high out-of-pocket maximums.
The Cheapest Health Insurance in Massachusetts With Low Out-of-Pocket Maximums
Health insurance plans in Massachusetts with low out-of-pocket maximums are good options if you have high medical costs compared to an average person. Although you need to pay a more expensive premium each month, your medical expenses allow you to reach policy limits faster. It, in turn, makes your insurance provider cover medical costs sooner than other plans.
A 40-year-old buyer who frequently visits the doctor or is required to purchase prescription drugs regularly can buy the cheapest health insurance in Massachusetts with low out-of-pocket maximums from BMC HealthNet Plan. Its Standard Platinum: BMC HealthNet Plan Platinum has a monthly premium of roughly $538.
MoneyGeek compared plans with out-of-pocket maximums lower than $4,250. Standard Platinum: BMC HealthNet Plan Platinum’s out-of-pocket maximum is $3,000.
BMC HealthNet Plan
BMC HealthNet Plan offers the cheapest plan with a low out-of-pocket maximum in Massachusetts. Being a Platinum plan, you need to pay a higher premium per month, but it could be more cost-effective in the long run. Having a low out-of-pocket threshold allows you to reach your limits sooner, causing your insurance provider to cover medical expenses earlier.
Cheapest HMO/EPO Health Insurance Plan in Massachusetts
Finding the best health insurance in Massachusetts depends on your specific needs and preferences. You can choose between HMO or EPO plans in Massachusetts, the former being more common in the state.
HMO (Health Maintenance Organization) plans are typically more affordable than other plans. If your in-network providers are readily available to you, this may be a better option. Although it requires you to stay within your network providers to ensure coverage, you’ll pay a lower premium per month. The cheapest HMO Silver plan is Standard Silver: BMC HealthNet Plan Silver A II provided by BMC HealthNet Plan. It costs an average of $367 per month.
EPOs, or Exclusive Provider Organization plans, offer the same advantages as HMOs. They cost less each month, but you’ll need to stay in-network except for emergencies. Unlike HMOs, however, you don’t necessarily need a referral to see a specialist. The cheapest EPO Silver plan is the Standard Silver: UHC Navigate Silver 2000 from UnitedHealthcare. It costs an average of $588 per month.
Cheapest Plan in Massachusetts With an HSA
If you’re in good health and don’t visit the doctor frequently, you may think paying for health insurance in Massachusetts per month is illogical. An option that may appeal to you is opening a Health Savings Account (HSA). These plans cost less, and they allow you to make pre-tax contributions. A medical emergency may cause you to dip into your savings, but if not, you can use it as your nest egg.
In Massachusetts, HSA plans are only available for the Bronze tier. The cheapest option is Standard High Bronze HSA: BMC HealthNet Plan Bronze provided by BMC HealthNet Plan, costing an average of $272 per month.
What to Know About Health Insurance in Massachusetts
MoneyGeek used private plans to complete this analysis, but it’s possible to find more affordable health insurance in Massachusetts once you apply for one through the Insurance Exchange. Older buyers should also check whether or not they qualify for Medicare or Medicaid. These are healthcare programs from the government and are likely to be cheaper than any private plan in the Insurance Exchange.
Private Health Insurance on the Massachusetts Marketplace
Plans from the Massachusetts Insurance Exchange are categorized in four tiers, each named after precious metals. You receive the same quality of care, regardless of which tier your plan is, but those named after more valuable metals cover a higher percentage of your medical costs.
Here’s an overview of each metal tier in Massachusetts to help you understand them better:
Bronze – Bronze plans cost you less per month than other plans, but they have high deductibles and out-of-pocket maximums. It may cost you more in medical emergencies since you shell out more before your policy kicks in.
Silver – Silver plans have lower premiums than Gold or Platinum ones but offer better coverages than Bronze plans. If you qualify for extra savings, you can save thousands of dollars a year. All these typically make Silver plans the best value-for-money health insurance plans in Massachusetts.
Gold – Gold plans require insurance providers to shoulder around 80% of your medical expenses. Although these cost more than Bronze or Silver plans each month, their deductible and out-of-pocket maximums are lower. This means you pay less out of pocket when you have medical expenses.
Platinum – Platinum plans have the most expensive monthly premiums but have the lowest thresholds for out-of-pocket maximums. They typically also have low deductibles. If you have regular medical expenses like frequent visits to the doctor or prescription drug purchases, Platinum plans may turn out to be more cost-effective in the long term.
Apart from the plans shown in MoneyGeek’s study, you can get cheaper health insurance plans in Massachusetts based on your income. If your annual earnings fall between 100% and 400% of the federal poverty level, you are eligible for premium tax credits. For example, a two-person household in Massachusetts with an annual income ranging from $17,420 to $69,680 can take advantage of these plans. You can use HealthCare.gov’s calculator to see how much you can save.
Every year, typically between November and December, open enrollment happens. This is when you can choose to purchase a new plan or renew the one you currently have. Presently, enrollment dates have been expanded due to COVID-19.
If you come from a two-person household earning $24,040 to $43,550 a year, you can also get cost-sharing reductions (CSR) if you opt for a Silver plan. An annual income falling between 138% to 250% of the federal poverty line qualifies you for it, resulting in reduced deductibles, copayments or coinsurance and lower out-of-pocket maximums. If you put these all together, you may end up with a Gold plan coverage while paying Silver plan costs.
Medicaid in Massachusetts
Medicaid is a government healthcare program that you can get for free, making it the cheapest option for those who qualify. Massachusetts is a Medicaid expansion state, which means income is the sole factor for eligibility. If your income is below the federal poverty line by at least 138%, you can apply for Medicaid.
Medicare in Massachusetts
Another government healthcare program you could qualify for is Medicare. It’s for buyers who are 65 or older or have an illness or disability that makes them eligible. Unlike Medicaid, Medicare requires you to pay for some coverage. Compared to purchasing a private policy, however, Medicare is still more affordable.
Medicare comprises of three parts, each covering a specific area of medical expenses:
- Part A: This provides coverage for inpatient stays, care from skilled nursing facilities and hospices. Some home health care is also covered.
- Part B: This provides coverage for outpatient care, services from selected doctors, preventive services and medical supplies
- Part D: This provides coverage for prescription drugs, vaccines and other recommended shots
Expert Advice: Finding Affordable Health Insurance in Massachusetts
- How do I take advantage of cost-sharing reductions and tax credits for health insurance in Massachusetts?
- Outside of plans on the health insurance exchange, where else can I get health insurance in Massachusetts?
Professor of Economics at the Massachusetts Institute of Technology
Associate Professor of the Practice of Economics and Research Fellow at the Center for Retirement Research at Boston College
Methodology
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in Massachusetts for you
MoneyGeek collected plans and premiums for health insurance in Massachusetts from the website for Massachusetts Health Connector for all available metal tiers and across several age groups. Plans and premiums were analyzed in May 2021.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About Mark Fitzpatrick
sources
- American Hospital Association. "Your Zip Code, Your Health." Accessed July 16, 2021.
- HealthCare.gov. "How Insurance Companies Set Health Premiums." Accessed July 16, 2021.
- Medicare. "What’s Medicare?." Accessed July 21, 2021.