In Massachusetts, you can choose between metal tiers with different deductibles, premiums and maximum out-of-pocket limits. Plans are priced based on age, income level and preferred amount of coverage. WellSense Health Plan offers the cheapest plans for Bronze, Gold and Platinum tiers. Tufts Health Plan Direct has the cheapest Silver and Catastrophic plans. United Health Care offers the cheapest EPO plan.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Massachusetts.
Most Affordable Health Insurance in Massachusetts
Cheapest Health Insurance in Massachusetts by Metal Tier
For Silver plans, the most affordable option in Massachusetts is the Standard Silver: Tufts Health Direct Silver 2000 II at $409 per month.
The cost of health insurance depends on the chosen metal tier. More valuable metal tiers require higher premiums but will provide more coverage. Here are some of the cheapest health insurance plans by metal tier with their average monthly premiums:
- Catastrophic: Tufts Health Direct Catastrophic ($297 per month for a 26-year-old)
- Bronze: Standard High Bronze HSA: WellSense Health Plan Bronze ($332 per month)
- Silver: Standard Silver: Tufts Health Direct Silver 2000 II ($409 per month)
- Gold: Non-Standard Low Gold: WellSense Health Plan Low Gold ($491 per month)
- Platinum: Standard Platinum: WellSense Health Plan Platinum ($625 per month)
Silver plans are often a good benchmark as these are relatively affordable and have the standard health care coverages. More valuable metal tiers will cost more, but they provide better benefits and lower out-of-pocket maximums.
Groupings of plans within the health insurance exchange are placed in metal tiers. Silver plans sit in the middle when it comes to cost and coverage. It also allows low-income individuals to opt for lower deductibles. More valuable metal tiers (like Gold and Platinum) have higher premiums and lower out-of-pocket expenses. Lower tier plans are ideal for young and healthy buyers, while higher tier plans are ideal for those working with a more flexible budget or those who expect to spend higher amounts on health care within a policy year.
Cheapest Silver Plans in Massachusetts
Standard Silver: Tufts Health Direct Silver 2000 II is the cheapest Silver plan in Massachusetts, costing around $409 monthly. The top three most affordable Silver plans in Massachusetts include:
- Standard Silver: Tufts Health Direct Silver 2000 II: $409 per month from Tufts Health Plan Direct
- Standard Silver: WellSense Health Plan Silver A II: $421 per month from WellSense Health Plan
- Standard Silver: Community Care Connector High Silver II: $435 per month from Fallon Health
Silver plans are a good option to consider since they offer decent coverage with lower deductibles. There are also cost-sharing reductions available only for Silver plans that can help lessen your deductibles, copay and out-of-pocket expenses.
MoneyGeek focuses its recommendations on the HMO plan type as it is the most accessible type in Massachusetts.
Cheapest Gold Plans in Massachusetts
The cheapest Gold plan in Massachusetts is the Non-Standard Low Gold: WellSense Health Plan Low Gold, which costs about $491 monthly. The cheapest Gold plans in Massachusetts include:
- Non-Standard Low Gold: WellSense Health Plan Low Gold: $491 per month from WellSense Health Plan
- Standard High Gold: WellSense Health Plan Gold: $503 per month from WellSense Health Plan
- Non-Standard Low Gold: Tufts Health Direct Gold 1600: $541 per month from Tufts Health Plan Direct
Because Gpld plans require higher monthly premiums, you can expect to pay less when you receive care. This is a good choice if you will need a lot of medical services or are willing to pay more upfront. One caveat is that there are no cost-sharing reductions in a Gold plan.
Cheapest Bronze Plans in Massachusetts
WellSense Health Plan offers the most affordable Bronze plan in Massachusetts. Its Standard High Bronze HSA: WellSense Health Plan Bronze costs approximately $332 per month. Here are some other affordable plans for the Bronze tier.
- Standard High Bronze HSA: WellSense Health Plan Bronze: $332 per month from WellSense Health Plan
- Standard High Bronze: Tufts Health Direct Bronze: $351 per month from Tufts Health Plan Direct
- Standard High Bronze: Community Care Connector Bronze #1: $378 per month from Fallon Health
Bronze plans consist of higher deductibles, so you’ll pay the lowest monthly premiums but higher out-of-pocket costs for most or all of your routine care.
Cheapest Catastrophic Plans in Massachusetts
Tufts Health Plan Direct offers the lowest-cost Catastrophic plan in Massachusetts. Its Tufts Health Direct Catastrophic plan costs approximately $297 per month for a 26-year-old. The other cheapest Catastrophic plans in the state include:
- Tufts Health Direct Catastrophic: $297 per month from Tufts Health Plan Direct
- HMO Blue Essential: $351 per month from Blue Cross Blue Shield
Catastrophic plans are generally extremely affordable but have high out-of-pocket costs. They have limited age eligibility restrictions and are generally reserved for younger policyholders.
Cheapest Platinum Plans in Massachusetts
WellSense Health Plan offers the most affordable Platinum plan in Massachusetts. Its Standard Platinum: WellSense Health Plan Platinum costs approximately $625 per month. The other cheapest Platinum plans in Massachusetts include:
- Standard Platinum: WellSense Health Plan Platinum: $625 per month from WellSense Health Plan
- Standard Platinum: Tufts Health Direct Platinum: $675 per month from Tufts Health Plan Direct
- Standard Platinum: Community Care Connector Platinum: $770 per month from Fallon Health
Platinum plans consist of higher premiums but have the lowest out-of-pocket costs, potentially saving you money in the long run if you have consistent medical needs.
If you qualify for premium tax credits, such as having an income that is below 150% of the FPL, you might be able to apply for cost-sharing reductions on Silver plans. While this doesn’t lower your monthly premiums, it pays a higher share of medical expenses through deductibles, copay and out-of-pocket expenses.
For example, say the Standard Silver: Tufts Health Direct Silver 2000 II plan, where policyholders pay an average monthly premium of $409. A standard plan will have an average MOOP cost of $9,100, while those that qualify for cost-sharing reductions can access a lower MOOP.
Cheapest Health Insurance in Massachusetts by Plan Type
The most common plan type is a Health Maintenance Organization (HMO) plan. In Massachusetts, in addition to HMO plans, you can also choose from a number of Exclusive Provider Organization (EPO) plans.
The most affordable health insurance in Massachusetts for the different plan types are:
- EPO: Standard Silver: UHC Navigate Silver 2000 for $675 per month
- HMO: Standard Silver: Tufts Health Direct Silver 2000 II for $409 per month
Between HMO and EPO plan types, the difference lies in the network provider available to provide care. HMO plans require you to choose a primary care physician (PCP) that will refer you to specialists within its network of providers. EPO plans, on the other hand, allow you to seek services from in-network providers without having a referral before you can see a specialist.
As you shop for health insurance in Massachusetts, it’s important to know the difference between HMO and EPO plan types.
- HMO plans, the most common plan type, are the cheapest but also the least flexible. You’ll need a referral from a primary care provider before seeing a specialist. You’ll receive treatment from in-network facilities and providers, except for emergencies.
- EPO plans have more in-network providers, but unlike HMO plans, they may not require referrals for seeing a specialist.
Cheapest Health Insurance in Massachusetts by County
The availability of health insurance policies is not the same in all parts of Massachusetts. Rates can vary based on which county you live in. In the table below, you can see which Silver plans are available by county and how much they cost.
Health Insurance Costs in Massachusetts by Age and Metal Tier
Health insurance premiums vary based on metal tiers. Here’s how metal tiers impact the average monthly premium for a 40-year-old in Massachusetts:
- Catastrophic: $324 (due to eligibility restrictions, this rate is for a 26-year-old)
- Bronze: $519
- Silver: $610
- Gold: $694
- Platinum: $931
Opting for a more valuable metal plan can cost you more money upfront but may save you money in the long run if you have major medical needs.
In addition to metal tiers, costs vary based on age. For Silver plans, for example, 18-year-olds might pay around $329 monthly, while 60-year-old seniors could have premiums of roughly $1,036 monthly.
What to Know About Massachusetts Health Insurance
MoneyGeek collected data from private health insurance plans to identify the most affordable health insurance for policyholders in Massachusetts. There are thousands of available plans from the health insurance marketplace that meet different coverage levels and needs. The marketplace allows you to purchase a plan within the open enrollment period.
Other than the health insurance marketplace, there are also government-supported health insurance programs offered to low-income individuals (Medicaid) or seniors and those with disability (Medicare).
Private Health Insurance in the Massachusetts Marketplace
The health insurance marketplace has an open enrollment period starting from November 1 to January 15 each year. You can purchase a health insurance plan within this given time frame.
You’ll need to enroll before December 15 of the current year for policies that begin by January 1 of the following year. This early enrollment will ensure that you won’t have gaps in your coverage and are able to purchase a plan before your old policy expires.
There can be special cases where you’ll need to purchase health insurance outside the indicated enrollment period.
Special enrollment periods are only allowed for those that went through life events like marriage, relocation, loss of income, childbirth and other similar events. You have a window of approximately 60 days prior to or following the event, during which you can apply for or make changes to your health insurance.
Medicaid in Massachusetts
Medicaid is a program run by the government that offers medical coverage at low or no cost to eligible individuals, primarily based on their income. Other criteria, including being pregnant, having a disability or being a child with parents or guardians with low income, may determine your eligibility for Medicaid.
Medicare in Massachusetts
Another government-sponsored health care program called Medicare qualifies Massachusetts residents with a qualifying illness, disability or age of 65 and older to receive care at an affordable price.
Medicare is categorized into parts, and each covers a specific set of services:
- Part A covers inpatient services, hospice care, home care and services received in any facility with skilled nurses.
- Part B covers doctor and preventative service fees and outpatient treatment.
- Part D covers prescription drugs, vaccines and other shots.
MoneyGeek listed the best Medicare Advantage plans in Massachusetts.
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?
Associate Professor of the Practice of Economics and Research Fellow at the Center for Retirement Research at Boston College
Professor of Economics at the Massachusetts Institute of Technology
Massachusetts Health Insurance Frequently Asked Questions
People shopping for health insurance often have questions about the cost and availability of different health plans in Massachusetts. Here are some common questions.
About Mark Fitzpatrick
- HealthCare.gov. "Special Enrollment Period (SEP)." Accessed November 23, 2022.