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MoneyGeek Logo IconBestHealth InsuranceMassachusetts
2023

Best Health Insurance in Massachusetts

Best Overall for Health Insurance in Massachusetts

Tufts Health Plan Direct is the best health insurance provider in Massachusetts. With a MoneyGeek score of 88 out of 100, it offers cheap rates, affordable maximum out-of-pocket (MOOP) costs and superior claims processing. We assessed Silver health plans in Massachusetts for this category, which included five exclusive provider organizations (EPOs) and 212 health maintenance organizations (HMOs).

Tufts Health Plan Direct

pros

Processes all claims

Lowest average MOOP in Massachusetts

Most affordable premiums among eight insurers

cons

Only HMO plans available

COMPANY HIGHLIGHTS

MoneyGeek’s analysis finds that Tufts Health Plan Direct is the best health insurance company in Massachusetts. It offers 34 Silver HMO plans and features the cheapest monthly premium at approximately $409.

Moreover, at roughly $9,100, its MOOP cost is relatively affordable and can help you lower your overall medical expenses.

Notably, Tufts Health Plan has a claims denial rate of 0%, meaning it accepts all legitimate insurance claims. As such, you can be sure your valid coverage requests will be approved.

Plan Recommendations

MoneyGeek recommends Standard Silver: Tufts Health Direct Silver 2000 II from Tufts Health Plan Direct. On average, it costs $409 per month and comes with a MOOP of $9,100.

Best Health Insurance in Massachusetts for Low Out-of-Pocket Costs

MoneyGeek rates WellSense Health Plan as Massachusetts' best health insurance company for consumers who prioritize low out-of-pocket costs. This provider offers low premiums, outstanding claims management and low MOOP costs, gaining a MoneyGeek score of 88 out of 100. Our analysis concentrated on Gold and Platinum health plans in Massachusetts, comprising 13 EPOs and 542 HMOs.

WellSense Health Plan

pros

Processes all valid claims

Affordable MOOP costs

Offers the cheapest rates

cons

Only offers HMO plans

COMPANY HIGHLIGHTS

If you're searching for health insurance with low MOOP costs in Massachusetts, WellSense Health Plan is your best bet.

WellSense offers 30 Gold HMO plans and 15 Platinum HMO plans with an average monthly cost of $625, the most affordable in the state. Moreover, it features a low MOOP cost of $3,000, matching the standards of more expensive plans in Massachusetts.

What's more, the company has a reputation for promptly accepting all valid insurance claims, meaning you can count on hassle-free coverage.

Plan Recommendations

If you're looking for health insurance plans with low maximum out-of-pocket costs, our top recommendation is WellSense Health Plan's Standard Platinum: WellSense Health Plan Platinum. This plan features an affordable average monthly cost of $625 and a low MOOP of $3,000.

Best Cheap Health Insurance in Massachusetts

Tufts Health Plan Direct is the top affordable health insurance provider in Massachusetts, earning a MoneyGeek score of 94 out of 100.

Among the eight companies we surveyed, Tufts Health Plan Direct has the lowest average plan cost at $409 per month. Although we placed a heavier emphasis on affordability when selecting the winner in this category, it's worth noting that low-premium plans often have higher out-of-pocket costs.

We evaluated five EPOs and 212 HMOs in Massachusetts to make our selection.

If you're focused soley on cost, MoneyGeek also determined the cheapest health insurance in Massachusetts.

Tufts Health Plan Direct

pros

Excellent claims processing

Affordable MOOP

Has the cheapest rates

cons

Limited plan selection

COMPANY HIGHLIGHTS

MoneyGeek rates Tufts Health Plan Direct as the top affordable health insurance provider in Massachusetts, with an average monthly premium of $409 and a MOOP cost of $9,100. It offers 34 Silver HMO plans in the state.

Aside from its affordability, Tufts Health Plan Direct is also known for its effective claims management, with a 0% denial rate. With this provider, you can have peace of mind knowing your coverage requests will be processed efficiently, and you won't be left to pay your medical expenses out of pocket.

Plan Recommendations

MoneyGeek recommends Tufts Health Plan Direct’s Standard Silver: Tufts Health Direct Silver 2000 II, which costs around $409 per month and has an average MOOP of $9,100.

Best Health Insurance for Young Adults in Massachusetts

MoneyGeek picks WellSense Health Plan as the top health insurance provider for young adults in Massachusetts with a score of 88 out of 100.

Our analysis focused on Bronze and Catastrophic plans, which have low monthly premiums but high out-of-pocket costs. Catastrophic plans are available only to individuals under 30 or those who qualify for a hardship exemption. For this category, we analyzed five EPOs and 247 HMO plans.

WellSense Health Plan

pros

Top-notch claims management

Low out-of-pocket costs

Comes with the cheapest premiums

cons

Options limited to HMO plans

COMPANY HIGHLIGHTS

If you’re a young adult in Massachusetts, MoneyGeek recommends WellSense Health Plan. It offers the cheapest monthly premium rate among eight insurers at an average of $282 per month for 26-year-olds. Additionally, its MOOP cost is around $7,500, which is the lowest in this category in the state.

WellSense Health Plan offers 15 Bronze HMO plans. It has a reputation for efficient claims processing and accepts all valid coverage requests, with a 0% claims denial rate.

Plan Recommendations

MoneyGeek suggests WellSense Health Plan’s Standard High Bronze HSA: WellSense Health Plan Bronze. It costs roughly $282 per month for 26-year-olds and $179 per month for 18-year-olds. Its average MOOP is $7,500.

Best Health Insurance by Plan Type in Massachusetts

Health insurance providers typically offer a variety of plan types that differ in benefits, coverage, cost-sharing and network options. After analyzing providers in Massachusetts, we find that Tufts Health Plan Direct offers the best HMO plans, and UnitedHealthcare provides the top EPO plans.

In our evaluation, we focused on Silver plans, which strike a balance between affordable premiums and lower out-of-pocket costs. Our recommendations are tailored to Silver plans. We assessed five EPO and 212 HMO options for this category.

Best for HMO: Tufts Health Plan Direct

Tufts Health Plan Direct
COMPANY HIGHLIGHTS

MoneyGeek chose Tufts Health Plan Direct as the best HMO provider in Massachusetts. With an average monthly cost of around $409, Tufts Health Plan Direct's plans offer affordability to consumers. Additionally, the plans have a maximum out-of-pocket (MOOP) cost of $9,100, ensuring that individuals are protected from excessive expenses.

Beyond its cost advantages, Tufts Health Plan Direct has a reputation for exceptional claims management. Policyholders can expect efficient and hassle-free processing of their valid coverage requests.

Tufts Health Plan Direct offers 34 Silver HMO plans in Massachusetts.

Plan Recommendations

MoneyGeek recommends Tufts Health Plan Direct’s Standard Silver: Tufts Health Direct Silver 2000 II, which costs roughly $409 per month and features an average MOOP of $9,100.

Best for EPO: UnitedHealthcare

UnitedHealthcare
COMPANY HIGHLIGHTS

UnitedHealthcare is the best EPO provider in Massachusetts, offering affordable plans with an average monthly cost of around $675 and a MOOP cost of $9,100.

Further, UnitedHealthcare is known for its effective claims management, which ensures efficient and hassle-free processing of coverage requests.

It's worth noting that UnitedHealthcare has a limited selection of Silver plans in the state, with only five EPO options available.

Plan Recommendations

MoneyGeek recommends Standard Silver: UHC Navigate Silver 2000 from UnitedHealthcare, which costs roughly $675 per month and features an average MOOP of $9,100.

How to Find the Best Health Insurance for You in Massachusetts

When purchasing health insurance in Massachusetts, finding the best plan for your needs and budget is crucial. Here are two key factors to consider when shopping for a health insurance plan.

  • doctor icon

    Understand when a health insurance plan will cover you

    HMO plans require a primary care physician and referrals for specialists. In contrast, EPO plans offer the flexibility to see both in-network and out-of-network providers without referrals. You may save money on premiums with an HMO plan, but not if you have to pay more to see an out-of-network provider. In Massachusetts, you can choose from 1,001 HMOs and 23 EPOs.

  • money2 icon

    Weigh the cost of premiums vs. the cost of care

    Although low-premium health insurance plans may initially appear appealing and offer short-term savings, they frequently entail higher out-of-pocket costs. This may potentially lead to higher overall annual medical expenses.

    For instance, in Massachusetts, Tufts Health Plan Direct's Standard Silver: Tufts Health Direct Silver 2000 II plan has a monthly cost of approximately $409 and a maximum out-of-pocket (MOOP) limit of $9,100. In contrast, its Standard Silver: Tufts Health Direct Silver 2000 II plan has an average monthly cost of $675 and a MOOP of $3,000.

Consider Massachusetts Medicare or Medicaid if You’re Eligible

If you are a Massachusetts resident over 65 or have a qualifying disability or illness, you may be eligible for Medicare. This is a federal government program assisting with certain medical services. Although some form of payment may still be required, the program covers the following services:

  • Part A: This covers inpatient stays, care from skilled nursing facilities, hospice care and some home health care.
  • Part B: This covers outpatient care, services from selected doctors, preventive services and medical supplies.
  • Part D: This covers prescription drugs, vaccines and other recommended shots.

Frequently Asked Questions About Health Insurance in Massachusetts

When searching for health insurance in Massachusetts, you may have concerns regarding costs and availability. To assist you in finding the right plan for your specific needs, we've addressed some commonly asked questions.

About Mark Fitzpatrick


Mark Fitzpatrick headshot

Mark Fitzpatrick is a senior content director at MoneyGeek with over five years of experience analyzing the insurance market, conducting original research and creating content that can be personalized for every buyer. He has been quoted on insurance topics in several publications, including CNBC, NBC News and Mashable.

Mark earned a master’s degree in Economics and International Relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his economics and insurance knowledge to bring transparency around financial topics and help others feel confident in their money moves.