PROVINCETOWN — This year’s “open enrollment” period on the state’s Health Connector website — that is, the window of time in which people without health insurance can easily sign up for it, and those who have expensive plans can shop for cheaper ones — is ending on Jan. 23. After that, Massachusetts residents can change health plans only if something unusual has happened in their lives — like a change in employment, residence, or marital status — until open enrollment begins again in November 2024.
This year’s open enrollment period is a particularly important one because the state has funded a large expansion of low-cost “ConnectorCare” plans, said Suzanne Joyner, the senior health-care access specialist at Outer Cape Health Services.
Many people who previously qualified only for the less-subsidized “metal plans” — that is, the Bronze, Silver, Gold, and Platinum plans sold by various health insurance companies like Blue Cross Blue Shield, Boston Medical Center, and Tufts Health — are now eligible for deeply subsidized ConnectorCare plans, which offer similar coverage but have much lower premiums and copays, Joyner said.
ConnectorCare plans also have no deductibles, which can mean thousands of dollars in savings for people with health conditions that require more care.
“The income limit for ConnectorCare had been 300 percent of the federal poverty level, currently $43,470 for a single person or $90,000 for a family of four,” said Joyner. “The new increase in ConnectorCare to 500 percent of poverty level means the limit for a single person is $72,900 and for a family of four is $150,000,” she said.
Joyner said she sees many people earning at this level who sign up for a plan and then end up unable to pay for it — those who can’t afford $400 or $500 a month in premiums.
People who are currently enrolled in a “metal plan” and are now eligible for a lower-cost ConnectorCare plan should be notified through the mail and automatically moved over to ConnectorCare, Joyner said.
But people who are currently going without insurance because it was too expensive in the past — especially people in their 50s and early 60s, ages at which individual plans can become very costly — might not know about the expansion of ConnectorCare, Joyner said.
“I fear that those are the people who will continue to drop through the cracks,” Joyner said, “until they hear about it.” She hopes that will happen before year’s open enrollment period.
A Complex System
The expansion of ConnectorCare was announced in August, when Gov. Maura Healey signed the state budget for fiscal 2024. The “pilot expansion,” which lasts for two years, is expected to bring 50,000 more residents into ConnectorCare, which currently serves about 156,000 people.
Those numbers are relatively small because many people in these income ranges have access to employer-based health insurance and are therefore not eligible for ConnectorCare. More than 2 million residents are on MassHealth, which is the state’s version of the federal Medicaid program.
But ConnectorCare also covers some people whose income might normally make them eligible for MassHealth. Joyner said that legal nonimmigrant workers, such as J-1 and especially H-2B visa workers, are often covered by ConnectorCare.
“I have been working in this field since 2007, when the whole Health Connector started,” Joyner said. “Employers are very good about letting their employees know they can get health insurance, and a significant percent of the population I see are seasonal employees whose employers have notified them,” Joyner said.
International students with J-1 visas sometimes pay for a single visit to Outer Cape Health Services on a sliding scale, Joyner said. If they need care from a specialist, Joyner said she helps them fill out the application that covers various state programs, including ConnectorCare.
The Health Connector website now includes a “Get an Estimate” tool that allows people to enter their ages, household incomes, and zip codes to find out how much health insurance might cost them without going through a full application process.
According to the estimate tool, a 60-year-old in Provincetown who makes $70,000 per year would have paid $462 per month for a Boston Medical Center Silver plan but can now pay $255 per month for a ConnectorCare plan from BMC.
A Blue Cross Blue Shield Silver plan that would have cost $1,210 per month would now cost $799.
Joyner also said that everyone who buys insurance on the Health Connector should consider checking to see if their insurance carriers are still price-competitive.
“Some of these plans are pricey, and I encourage everyone to look and see what their other options are,” Joyner said. “I don’t know how anyone can afford some of these plans.”
