The Online Resource for Massachusetts Poverty Law Advocates

ConnectorCare-Basic Info Needed to Select a Plan

Date: 
04/13/2015
Author: 
Health Connector

ConnectorCare is the name for those private plans purchased through the Health Connector with the lowest premium & cost sharing for individuals with income that does not exceed 300% of the poverty level. It is comparable to the former Commonwealth Care program.  Once found eligible for ConnectorCare, people have to select a plan before their coverage begins. There are only seven  managed care organizations (MCOs) that offer ConnectorCare plans in 2015. Each of these MCOs also offer other kinds of plans that are not ConnectorCare plans. The choice of MCO does not affect the scope of covered benefits or cost sharing; these will be the same for each type of ConnectorCare Plan, Plan Types 1, 2, or 3. For people over the poverty level, the choice of MCO does affect the amount of monthly premium contributions. For those at or below poverty, there is no premium contribution regardless of MCO choice. For people at all income levels, the choice of MCO affects which doctors, hospitals, and other providers are included in the plan's network and available to treat people enrolled in that MCO's plan. The following information can help your clients select the MCO they can best afford and that includes the doctors and hospitals they want to see.

1. Health Connector flyer describing covered benefits and cost sharing in ConnectorCare Plan Types 1, 2 and 3, the lowest possible premium contribution by income group, and the name of 7 ConnectorCare MCOs.

2.List of the 7 MCOs that offer ConnectorCare Plans, the specific name of the MCO's ConnectorCare Plans (Plan Types 1-3), and the MCO's website.  Some providers may participate in an MCO's commercial plans sold through the Connector but not in any of the MCO's ConnectorCare plans. When asking a provider if he or she participates in an MCO or checking an MCO's website, be sure you and your client are checking whether a provider is in the MCO's ConnectorCare plan.

3. A powerpoint showing which ConnectorCare MCOs are available in each region of the state and what the premium charge is for each MCO. The lowest possible premium contributon will always be available for at least one MCO in a region, but choosing another MCO may mean a higher premium contribution for those with income over the poverty level.

4. Link to ConnectorCare page on the Connector's website --this includes a list of which hospitals & community health centers participate in which ConnectorCare MCOs

 

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