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.

$2,000/$4,000*

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