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Massachusetts Obamacare

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Massachusetts 2023 Obamacare Rates

Learn about the 2023 rates for Obamacare in Massachusetts.

What Massachusetts Residents Need to Know About Obamacare for 2023

In Massachusetts, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2023 coverage.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in Massachusetts:

1. Massachusetts law requires you to have health insurance.

Obamacare's federal tax penalty went away in 2019. But Massachusetts has had its own health insurance requirement since 2006. That means most Massachusetts residents must have health insurance or face a state tax penalty. The penalty applies only to adults, and the cost depends on your income and the rates for various health plans offered in the state. (You can find the most recent penalty amounts in this document from Mass.gov.)

To find out if your current health plan complies with state law or to learn whether you qualify for an exemption, see Do I Have to Get Health Insurance in Massachusetts?

2. Massachusetts open enrollment has ended, but you may be able to use a special enrollment period to get covered.

In Massachusetts, open enrollment for 2023 Affordable Care Act (Obamacare) coverage has ended. This means that, unless you qualify for an exception or your income is low enough for Medicaid, you won't be able to get health insurance through Massachusetts Health Connector until open enrollment for 2024 begins next fall.

If you’ve lost your job or significant income in the past 60 days, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current one outside the open enrollment window.

In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Missed the Massachusetts Obamacare Enrollment Deadline?

3. You may qualify for new Affordable Care Act subsidies.

In 2021, President Biden signed the American Rescue Plan Act (ARPA). The law provided $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis, including additional premium subsidies for those who purchase health insurance through Massachusetts Health Connector. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Also, Massachusetts offers its own financial assistance programs. Here's a quick summary of the main programs available to you:

Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Massachusetts Health Connector. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums.

Cost-sharing subsidies. More than half of the people who purchase coverage through Massachusetts Health Connector receive assistance through cost-sharing reductions (CSRs). CSRs automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital.

CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2023 health plans, that means a family of four in Massachusetts can't earn more than $75,000 and an individual not more than $36,450.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at the costs for silver plans available at Massachusetts Health Connector while shopping for coverage.

Massachusetts subsidies. The Commonwealth of Massachusetts offers its own set of subsidies for those who earn less than 300% of the federal poverty level. You can find out whether you qualify for these subsidies when you apply for a plan at Massachusetts Health Connector.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through MassHealth in Massachusetts.

For more information, see Ways to Save Money on Obamacare in Massachusetts. You may also want to watch the video presentation Need Health Insurance? New Savings Are Here Through the Health Connector, presented by Massachusetts Health Connector.

4. Average premium rates went up for 2023, but that doesn't mean everyone is paying more.

Nationwide, the average rate increase for 2023 health plans was about 7.7%. However, these numbers aren't final; more importantly, this doesn't tell you how much you'll pay for health insurance. Costs vary from state to state and plan to plan within a state. For example, Texans are looking at an average premium increase of more than 8% while Virginians, generally, will benefit from an average decrease of about 13%. Also, if premiums for the benchmark plan (the plan used to determine subsidy amounts) go up, subsidies will also go up. This is a long way to say don't let the numbers scare you. Comparison shop at Massachusetts Health Connector to find the plans and subsidies available to you.

5. You can get help signing up if you need it.

The Biden administration has greatly increased enrollment assistance, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in Massachusetts.

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How To Sign Up for Obamacare in Massachusetts

For 2023 health plans, Massachusetts open enrollment has ended. However, you may still be able to purchase health insurance for this year if you qualify for a special enrollment period. For example, if you’ve recently lost your job or significant income, you might qualify for a 60-day special enrollment period that will allow you to sign up for a new health insurance plan. (See What Happens If I Missed the Enrollment Deadline?)

To sign up for a health plan under the Affordable Care Act (Obamacare) you can go directly to the online health insurance marketplace for Massachusetts. If you need personalized help, you can reach out to one of the many types of enrollment assistants working remotely during the COVID-19 crisis.

Where's the Massachusetts Health Care Exchange?

You can find the health insurance exchange for Massachusetts at Massachusetts Health Connector. This is where you can learn about the various health insurance options available to you under Obamacare. If you see a plan you like, you'll be guided through the enrollment process online. 

Getting Personalized Help with Enrollment

In Massachusetts, if you need help understanding your options for coverage under Obamacare or signing up for a plan, you can get free help from a trained enrollment assistant. 

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How Much Does Obamacare Insurance Cost in Massachusetts?

This article explains the costs of health care plans offered under the Affordable Care Act (commonly called Obamacare) for individuals or families who are currently uninsured or not covered by a job-based health plan.

What you'll pay for an Obamacare plan depends on five things:

  1. The level of coverage you choose
  2. Whether you qualify for a subsidy
  3. Where you live in Massachusetts
  4. Your age
  5. Whether you smoke

Read on to learn more about each of these factors.

1. The Level of Coverage You Choose

Obamacare insurance plans offer four levels of coverage:

Platinum -- covers approximately 90% of health care costs
Gold -- covers approximately 80% of health care costs
Silver -- covers approximately 70% of health care costs
Bronze –- covers approximately 60% of health care costs

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Massachusetts Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?

The Affordable Care Act (Obamacare) expanded Medicaid eligibility to include more people who couldn’t otherwise obtain health insurance. As written, the ACA would extend Medicaid to all adults with incomes at or below 138% of the federal poverty level. (For a single person in Massachusetts in 2021, that’s $20,120. For a family of four, it’s $41,400.)

However, the U.S. Supreme Court later ruled that it was up to individual states to decide whether to expand Medicaid. As of October 2021, 12 states have not expanded their programs.

Massachusetts Has Expanded Medicaid

Because Massachusetts did decide to expand its Medicaid program, residents can qualify for Medicaid more easily today than in years past.

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Massachusetts Has Its Own Tax Penalty for Being Uninsured

In Massachusetts, you may be required to pay a state tax penalty if you don't have health insurance.

Since 2006, Massachusetts has imposed a state tax penalty on adults who don't have minimum creditable coverage (MCC). Now that the federal Affordable Care Act penalty has been set to zero, uninsured folks need not grapple with two different sets of penalties -- but you should know the rules for going without health insurance in Massachusetts.

The Massachusetts tax penalty depends on your income, age, and family size. You can find the penalty chart for tax year 2019 on Mass.gov, which you will have to pay when you file your tax return in April of 2020. Generally, your penalty can't be more than half of the annual cost of the lowest priced plan available to you through Massachusetts Health Connector.

There are many situations in which you may be exempt from paying the penalty. For example, you won't have to pay if you can show that health insurance wasn't affordable or that you couldn't buy insurance due to a hardship.

To find out what qualifies as minimum creditable coverage (MCC) in Massachusetts and whether you are exempt from obtaining it, see Do I Have to Get Health Insurance in Massachusetts?



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Understanding Obamacare's Preventive Health Care Benefits

Get vaccinations, mammograms, colonoscopies, and other essential services for free

The Affordable Care Act requires health insurance plans to offer certain preventive care services free of charge -- or more accurately, for nothing more than the cost of your monthly insurance premiums. This rule applies to most plans sold directly by insurance companies and all plans sold through the health care marketplace for Massachusetts. Covered preventive services are available for free (meaning no co-pay or other out-of-pocket charges) whether or not you’ve met your plan’s annual deductible.

Tips for Using Your Preventive Care Benefits – And Avoiding Unexpected Charges

Below, you’ll find a list of free preventive benefits -- screening tests, counseling services, and vaccinations -- for adults, women, and kids. But first, here are some pointers to help you avoid an unexpected bill for services you thought were preventive.

Use a network provider. To get a preventive service for free, you must use a health care provider in your insurance plan’s network.

Know the difference between “preventive” and “diagnostic.” Doctors can use screening tests for either preventive or diagnostic reasons. For example, having a routine mammogram every year or two is preventive care for women over 40. But if you schedule a mammogram because you feel a lump or have breast pain, that’s diagnostic. Likewise, a routine colonoscopy is recommended for adults over 50, but if your doctor schedules a colonoscopy to investigate a problem like blood in your stool, it becomes a diagnostic procedure. Preventative services are free; diagnostic procedures are not. (If the timing is right -- say, you go to the doctor because you find a lump in your breast but you also happen to be due for an annual mammogram -- your doctor may bill the diagnostic procedure as preventive, but that’s not something you can count on.)

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Get Help Finding a Health Insurance Plan in Massachusetts

Get Help From the Massachusetts Health Insurance Exchange

The following links and telephone numbers take you to the official help resources for Massachusetts Health Connector, the health insurance marketplace for Massachusetts.

Get help by phone: 877-623-6765 (TTY: 877-623-7773)

Get help in person: To find a Massachusetts certified helper, use the Enrollment Assister Search page at Massachusetts Health Connector.

Get Help From a Licensed Insurance Broker

To directly connect with a Massachusetts insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

More Information

For more detailed information, see How Do I Sign Up for Obamacare in Massachusetts?



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Obamacare for Self-Employed Massachusetts Residents

Many self-employed people will be quick to tell you that getting and paying for health insurance is one of the biggest challenges they face. For some, however, the Affordable Care Act (Obamacare) may make things easier by providing new coverage options for the self-employed.

Are You Self-Employed or an Employer? 

Before you start evaluating your options for health coverage, you need understand whether the Affordable Care Act thinks you're self-employed.

The ACA says you are self-employed if you are an independent contractor or a sole proprietor without employees. (If you hire other independent contractors to do some work for you, you probably still qualify as self-employed.) If you are self-employed, you can use Massachusetts Health Connector to compare health insurance plans and sign up for the one that works best for you.

If you have employees – usually, workers whose income you report on a W-2 at the end of the year -- you’re considered an employer. In that case, you can learn about purchasing health insurance for yourself and your employees through the SHOP Marketplace. You will be connected with a registered SHOP (Small Business Health Options) agent or broker who can help you understand your coverage options.

If you aren’t sure whether the people who work for you are independent contractors or employees, read "Independent Contractor (Self-Employed) or Employee?" on the IRS website.

What the Affordable Care Act (Obamacare) Means for Self-Employed People in Massachusetts

Here are seven things self-employed people should know about the Affordable Care Act:

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What Domestic Partners Need to Know About Applying for Health Insurance Under Obamacare

When registered domestic partners or civil union partners apply for coverage at an Affordable Care Act health insurance marketplace, there’s one question that almost always arises: Do we apply based on our separate incomes or must we include all the income we make as a couple?

The answer depends on the state where you live.

States other than California, Nevada, or Washington. In almost all states, registered domestic partners or civil union partners who apply for insurance via the state’s health insurance exchange must do so separately. Each partner includes only his or her separate income, and this amount determines health plan costs and eligibility for cost-saving subsidies. It works this way because domestic partners are not considered married for federal tax purposes. (If you registered first and got legally married later, this article doesn't apply to you. You must apply as a married person and report your combined income.)

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Massachusetts Obamacare Scams: What They Are, How to Avoid Them & Where to Report Them

If someone calls you on the phone in Massachusetts offering you discount health insurance for $29 a month, hang up and report them to the Massachusettes Consumer Affairs and Business Regulation Office. 

Worthless insurance is one of many scams that unscrupulous people are trying to sell to consumers confused by Obamacare. To satisfy the requirements of the new law, you must have a qualified insurance plan. If you don't, not only will you miss out on cost-saving insurance subsidies, you will probably be subject to a tax penalty.

Beware of scammers who may try to persuade to you buy insurance outside of Massachusetts Health Connector. Below is a list of common types of scams.

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Obamacare and Seniors

If you’re over the age of 65, your health insurance options under the Affordable Care Act (Obamacare) depend on whether or not you’re covered by Medicare or another insurance plan. To find out what, if anything, you need to do, find the situation below that applies to you.

You have Medicare. If you’re already enrolled in Medicare, you’re considered covered under the ACA, and you don’t have to do anything. In fact, it’s illegal for someone who knows you have Medicare to try to sell you a plan through an ACA health insurance marketplace.

The Affordable Care Act does enhance your existing Medicare coverage by providing additional preventive care benefits, such as cancer screenings and an annual wellness visit.

For more information on Medicare coverage, go to Medicare.gov.

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Can I Use a Paper Application to Get Obamacare?

When Obamacare first launched, the federal and state health insurance marketplaces (also called “exchanges”) were plagued by technical troubles. Many people who tried to sign up for new health insurance plans online in the early days were unable to complete their applications.

Because of these difficulties, some individuals and application assistants turned to the old-school way of getting health insurance -- paper applications.

Applying on Paper May Not Be Better or Faster

When facing a slow or broken online health insurance exchange, using a paper application may seem tempting -- at least it would provide the feeling of getting something done. However, paper forms may not speed up the process at all. On the contrary, they could slow down your application even more.

The worker who reviews your paper application must manually enter the information from your forms into the same system you would use online at your state’s exchange. It won’t work any faster for them than it does for you. Plus, using a paper application opens up more opportunity for error by putting more people between you and your goal of getting insurance.

It’s still best to apply online if you can. That said, if you feel that you’re unlikely to come back and apply for health insurance later, you may want to go ahead and complete a paper application now. 

To get a paper application, call the Massachusetts Health Connector customer service center and let them know you want to apply on paper. They'll point you to a downloadable application or send you one in the mail. For detailed Massachusetts Health Connector contact information, see How To Sign Up for Obamacare in Massachusetts.



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When Are You Legally Required to Report “Life Changes” to the Massachusetts Health Insurance Exchange?

Are you planning to get married, change jobs, or move to a new state? If so, you might have to share your big news with Massachusetts Health Connector.

Which Changes Must You Report? 

If you buy a health insurance plan through the Massachusetts marketplace, the Affordable Care Act requires you to report changes that may affect your insurance coverage. These changes include: 

  • moving to a new state or insurance coverage area
  • significant changes in income
  • getting new health coverage through a job
  • signing up for Medicare or Medicaid
  • getting married or divorced
  • becoming pregnant, having a child, adopting a child, or placing a child for adoption
  • losing or gaining a dependent
  • becoming disabled, and
  • other changes that affect your income or household size.

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About This Website

We built this website to get people the answers they need about the Affordable Care Act (Obamacare). Our goal is to guide you to reliable, local information about your new health insurance options.

When you choose your state or enter your zip code here, you will quickly learn:

  • whether or not you're required to get health insurance

  • what the available plans cover

  • how much coverage will cost, and

  • how to sign up in your state.

For those concerned about cost, we show you how to determine whether you qualify for subsidies.

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