Compare Qualified Health Plans for 2019
To see which Qualified Health Plans you may qualify for, you need to first check your eligibility with the Massachusetts Health Connector. You can then choose your plan name below for more information.
| Plan Name |
Annual Deductible |
Annual Max Out-of-Pocket |
Office Visits |
Prescriptions 30-day supply |
ER Waived if admitted |
Hospitalization Per admission |
|---|---|---|---|---|---|---|
| Platinum |
Individual: $0* Family: $0* |
Medical: $3,000* Pharmacy, & Pediatric Dental: $6,000* |
PCP: $20 Specialist: $40 |
Tier 1: $10 Tier 2: $25 Tier 3: $50 |
$150 per visit | $500 |
| Gold |
Individual: $1,000* (Medical) Family: $2,000* (Medical) |
Medical: $5,000* Pharmacy, & Pediatric Dental: $10,000* |
PCP: $25 Specialist: $45 |
Tier 1: $20 Tier 2: $40 Tier 3: $60 |
$150 per visit after deductible |
$500 after deductible |
| Low Gold |
Individual: $2,000* (Medical) Individual: $250* (Pharmacy)
Family: $4,000* (Medical) Family: $500 (Pharmacy) |
Medical: $5,600* Pharmacy, & Pediatric Dental: $11,200* |
PCP: $30 Specialist: $55 |
Tier 1: $25 Tier 2: $50 after deductible Tier 3: $125 after deductible |
$350 per visit after deductible | $750 after deductible |
| Silver A |
Individual: $2,000 Family: $4,000* |
Medical: $8,150* Pharmacy, & Pediatric Dental: $16,300* |
PCP: $30 Specialist: $60 |
Tier 1: $30 Tier 2: $60 Tier 3: $100 after deductible |
$350 per visit after deductible | $1000 after deductible |
| Silver A II |
Individual: $2,000 Family: $4,000* |
Medical: $8,150* Pharmacy, & Pediatric Dental: $16,300* |
PCP: $30 Specialist: $60 |
Tier 1: $30 Tier 2: $60 Tier 3: $100 after deductible |
$350 per visit after deductible | $1000 after deductible |
| Silver B |
Individual: $3,000 Family: $6,000* |
Medical: $7,900* Pharmacy, & Pediatric Dental: $15,800* |
PCP: $30 Specialist: $55 |
Tier 1: $30 copay Tier 2: 35% coinsurance (all after deductible) Tier 3: 35% coinsurance (all after deductible) |
$500 per visit after deductible | 30% coinsurance after deductible |
| Bronze |
Individual: $2,900 Family: $5,800* |
Medical: $8,150* Pharmacy, & Pediatric Dental: $16,300* |
PCP: $30 after deductible Specialist: $60 after deductible |
Tier 1: $30 Tier 2: $60 after deductible Tier 3: $125 after deductible |
$350 per visit after deductible | $750 after deductible |
All preventive services are covered in full. Our plans meet the state mandate for health insurance coverage and offer a variety of cost sharing options to employers.
*See plan document for more information.