Question about health care for Mass residents

[wantingToGetOut]

Hi all,

I am an early retiree (44), who purchases health care for my family of three.

I think I have a basic understanding of how the national Patient Protection and Affordable Care Act will affect us should every thing work out by 2014.

I also know that Massachusetts has its own state health plan but I do not understand if we would be eligible.

Does anyone have some information on eligibility and such on the Mass Health Care plan? I want to make sure I am not leaving any obvious money on the table.

Thank you,

 

[Livefree]

Mass has a couple of options including Mass Health and Commonwealth Care. I think Commonwealth Care is the better of the two. It looks like the limit for a family of four is $69,156 in earnings. https://www.mahealthconnector.org/portal/site/connector

 

[Livefree]

I just realized you posted a family of three. The limit for that is: $57,276

 

[wantingToGetOut]

Thank you for the link.

In general, how does this work? Do you choose the plan, pay for it and then get money back when filling out your taxes when you can prove your agi is low enough?


Thanks for your help.

 

[Livefree]

I think you have to fill out a form to be accepted first, but not sure..I don't use it myself, as I'm still on the corporate plan for now.

 

[marko]

I would assume that once ACA is in full effect (2014) that the Fed subsidy will be available in some amount for those with an AGI of <400% FPL even for those in MA.

Looking things up today, I was unable to find anything with a High Deductible option in MA HI policies.

 

[ziggy29]

I would assume that once ACA is in full effect (2014) that the Fed subsidy will be available in some amount for those with an AGI of <400% FPL even for those in MA.

Looking things up today, I was unable to find anything with a High Deductible option in MA HI policies.

I would think federal law would supersede state law. If the federal subsidy is more generous than the MA state subsidy, I suspect the latter would go away.

Here's a link to a PDF document with FAQs about how federal law changes may affect the MA health care situation; some details are still TBD though it does say subsidies would be available up to 400% of the poverty line instead of the 300% under the state plan:

https://www.mahealthconnector.org/p...0Reform/Overview/National%20Reform%20FAQs.pdf

When I pull up quotes from the MA health care site, it says "all Bronze Low plans except Neighborhood Health Plan are HSA compatible" (if by "high deductible" you were looking for something that is eligible for an HSA).

 

[farmerEd]

Basically it works like this, if you are poor, you get the plan for free or next to free, if you are near poor, you can get some help with the premiums, and if you are not 'poor' (can't meet income guidelines), you are required to buy a plan. Keep in mind the plans you 'get' if you are on masshealth is not the same as the plans that you can buy on the open market; for example there is no Blue Cross option available to you, if the plan is subsidized or free, then you pick from the plans they tell you to pick from.

If you are an early-retiree, chances are you are not poor and may not qualify. There is a lot of paperwork you can fill out disclosing income and assets and the Dept of Health (MassHealth) will tell you what level of help they will give you, if any - you'll need to do this each year.

Also be aware, while Masshealth is WAY better than having no health insurance (and a lot cheaper than buying it), it generally will not give you access to any doctor you want, and there are a lot of things they won't pay for - some specialist won't see masshealth patients at all, and according to my wife (a nurse that deals with these types of issues all the time), many of the best doctors simply won't be available to you.

For the truly needy, its good that the program exists, if you are on the verge of being 'rich enough' not to qualify, you would need to figure out how much quality of care you are possibly willing to give up versus the amount of the money you may save.