Massachusetts Health Insurance

Last Updated on September 22, 2020 by Andrew Lee

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Throughout the years, Massachusetts has maintained its excellent health performance. Aside from its impressive overall health rating, it also has a laudable health care system. However, like all of the other states, rate increases for health insurance also took place this year. The good news is, the average is considerably lower than that of the nation. Read on to find out more about the key changes you should know about when it comes to coverage in the state this year.

The state’s health rankings also affect premiums

Another factor that has a heavy impact on premiums is the health performance of the residents of a particular location. And much thanks to the consistently impressive health rankings of Massachusetts, its consumers can enjoy lower rate increases.

In the 2015 State Health System Performance that The Commonwealth Fund conducted, the state ranked 4th of 51. It received quintile 1 scorecards (the highest possible) for four indicators, including “Access,” Prevention & Treatment,” “Healthy Lives,” and “Equity.” It had a less-than-stellar grade for “Avoidable Health Costs & Use” though, ranking only 31st.

Below are some key takeaways from its Healthy Lives scorecard:

  • Mortality amenable to healthcare: 60 out of 100,000 people
  • Breast cancer fatalities: 18.4 out of 100,000 women
  • Colorectal cancer fatalities: 13.1 out of 100,000 individuals
  • Percentage of adult smokers: 14%
  • Adult obesity: 23%
  • Obesity in children aged 10-17: 31%

The Access category focused on health insurance-related topics. The following are the findings for MA:

  • 5% of adults (19 to 64 years old) don’t have insurance, compared with the national average of 15%
  • 2% of children (infants to 18 years old) are uninsured, as opposed to the countrywide average of 6%
  • 8% of the adult population chose not to obtain insurance due to the high costs associated with it
  • 11% of adults had expensive out-of-pocket medical bills

Your coverage options and the portion your insurer will shoulder

As long as you have insurance, you can rely on your provider to cover a greater portion of the incurred medical and hospitalization bills. Of course, you will still have a share, but you have thousands of dollars less to worry about.

How big the portion your insurer will shoulder depends on the metal plan you have. Below are the reimbursements may receive, based on the metal tier:

Bronze – 60%

Silver – 70%

Gold – 80%

Platinum – 90%

The United States Department of Health & Human Services provided these projections on premium averages for this year in MA:

  • Second-lowest silver before advance premium tax credit (for a 27-year old with a $25,000 household income): $219
  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $142
  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $765
  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $405

Boasting of the lowest uninsured rating in the country

MA has long since had a low uninsured rating. However, in 2015, it had the lowest of all 50 states. You need to know this, because the more people who have coverage in a particular location, the greater your chances of having better premiums. According to a report from the U.S. Department of Health & Human Services, the state, with an estimated population of 6,794,422 (2015, latest data), only had a 2.8% uninsured rating in 2015. This represents a 1.6% drop from the 4.4% rating in 2010. Throughout the 5-year study, 107,000 more of its residents became insured.

Final reminders

While Massachusetts offers premiums lower than many of the other states in the country, know that you still have the chance to make it even more affordable. Check on available discounts you can qualify for, and make sure you compare offers from different providers to determine which one has the best and most suitable plan for you. Read this article for more information.