Qualified Health Plans

A Qualified Health Plan is a health insurance program available through the Massachusetts Health Connector. Depending on your income and family size, you may get help paying your monthly premium costs and the costs you pay for healthcare services.

To know for sure which program you qualify for, please apply at MAHealthconnector.org

To choose one of our Qualified Health Plans, you must live in the service area for that plan

Your choice of doctors and hospitals depends on where you live and which plan you pick.

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What do our Qualified Health Plans cover*?

When you select a plan, you get access to BMC HealthNet Plan’s provider network for that plan. Your plan will cover:

  • Doctor visits for preventive care
  • Specialist visits
  • Treatment at hospitals
  • Prescriptions 
  • ER visits when you have an emergency
  • Care before and after your baby is born
  • Well-care for your child
  • Extra help for special conditions like asthma and diabetes
  • Mental health and substance use services

Our Great Member Extras

Our members can get and stay healthy by taking advantage of Member Extras including:

  • Money back for participating in Weight Watchers® or a qualifying health club
  • Discounts on eyeglasses
  • FREE access to Good Measures dietitian services and nutrition coaching

To learn more about what medical services are covered, view your plan documents.

Need a Qualified Health Plan for your business?

Marketplace Rate Increase Justification

Rate increases are sometimes necessary for health plans sold on a health insurance marketplace. The rate increase justifications for BMC HealthNet Plan marketplace plans can be found on ratereview.healthcare.gov by selecting Massachusetts, Boston Medical Center, and searching the desired date range.

 

*Please see the current year's Qualified Health Plan Evidence of Coverage and Schedule of Benefits for specific information on each plan, including your covered benefits; exclusions; any restrictions to services, benefits or the provider network; and a summary of pharmaceutical management procedures. Learn more about available providers or a summary of utilization management procedures. Please see Your Privacy for our privacy policies.

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