Updated: May 22, 2024
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Best Health InsuranceMassachusettsBest Health Insurance in Massachusetts
Why Trust MoneyGeek? We downloaded plan data for Massachusetts directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
Blue Cross Blue Shield of Massachusetts, with a MoneyGeek score of 54 out of 100, offers the best health insurance in Massachusetts. This provider has plans with the lowest out-of-pocket costs and better-than-average claims approval rates. It also offers competitive plan prices.
We looked into 10 silver health insurance plans in Massachusetts to figure out which health insurance is the best.
Low out-of-pocket maximum costs
Fewer denied claims
Low score on offering affordable premium rates
Limited types of plans offered
MoneyGeek's top pick for the best health insurance in Massachusetts is Blue Cross Blue Shield of Massachusetts. This provider offers several Silver HMO plans.
Blue Cross Blue Shield's Silver HMO plans provide comprehensive coverage within its network of doctors and hospitals. HMO plans typically require choosing a primary care physician and getting referrals to see specialists. This provider offers an average plan rate of $822 with an average maximum out-of-pocket cost of $9,450 for these plans.
With a denial rate of 17%, Blue Cross Blue Shield of Massachusetts has an average denial rate compared to its competitors.
MoneyGeek recommends the following Silver plans:
Earning a MoneyGeek score of 51 out of 100, Blue Cross Blue Shield of Massachusetts provides the best health insurance for low out-of-pocket costs in Massachusetts. The company is known for low MOOP costs.
For our analysis, we reviewed three Gold or Platinum EPO plans and 25 Gold or Platinum HMO plans in Massachusetts.
Low out-of-pocket costs
Fewer denied claims than average
MoneyGeek's top pick for the best health insurance in Massachusetts for low out-of-pocket costs, Blue Cross Blue Shield, offers three Gold plans and one Platinum plan. These are metal levels known for helping to keep out-of-pocket costs down. The provider does not offer PPO plans but has HMO plans, which usually require choosing doctors and hospitals within their network.
This insurer offers an average plan rate of $753 with an average maximum out-of-pocket cost of $5,250. It also has a lower denial rate than most of its competitors. A lower denial rate shows customers have higher chances of their claims getting covered.
MoneyGeek recommends the following Gold and Platinum plans:
With a MoneyGeek score of 38 out of 100, Blue Cross Blue Shield of Massachusetts is the best cheap health insurance provider in Massachusetts. The provider has low maximum out-of-pocket fees and fewer claims denials than other providers.
For this analysis, we evaluated 10 Silver plans (one Silver EPO and nine Silver HMO plans). Our review focused on plans with lower monthly premiums, even though these can often lead to higher out-of-pocket costs.
Low maximum out-of-pocket costs
Lower claims denial rate
High premium costs
Limited plan options available
MoneyGeek's top pick for the best cheap health insurance in Massachusetts is Blue Cross Blue Shield of Massachusetts. It offers one Silver HMO plan. HMO plans generally have a network of doctors and hospitals that the insured needs to stick to for the lowest costs.
It offers an average plan rate of $822 with an average maximum out-of-pocket cost of $9,450. Blue Cross Blue Shield of Massachusetts has a denial rate of 17%, a much decent rate compared to most of its competitors.
Plan Recommendations
MoneyGeek recommends the following cheap Silver plan:
Earning a MoneyGeek score of 42 out of 100, UnitedHealthcare offers the best health insurance for young adults in Massachusetts. The provider has lower out-of-pocket costs and provides better-than-average health care insurance options for this age group. On the other hand, only young adults under 30 years old can purchase Catastrophic plans.
We evaluated one Bronze EPO, 11 Bronze HMO and two Catastrophic HMO plans for this category.
Low out-of-pocket maximum cost
Variety of plan types offered
Higher claims denial rating
Limited plan types offered
MoneyGeek's top pick for the best health insurance for young adults in Massachusetts is UnitedHealthcare. Young people sometimes choose insurance that covers less because they don't go to the doctor as often as older people do. UnitedHealthcare has one Catastrophic plan, one Bronze plan and one Expanded Bronze plan. The plans cost around $308 a month and have an annual average maximum out-of-pocket costs of $8,000.
UnitedHealthcare doesn't offer PPO plans but does have EPO plans, which often have lower monthly premiums. The provider's denial rate is about 32%, a rate much higher than most of its competitors.
Plan Recommendations
MoneyGeek recommends the following plan for young adults:
Health insurance companies have different plans to offer. The best providers for all plan categories available in the state are:
MoneyGeek's recommendation is to use only Silver plans. Silver plans offer a good balance between your monthly premium and what you pay when you need care. Silver plans work well for people who rarely go to the doctor. In Massachusetts, one Silver EPO and nine Silver HMO plans are available.
MoneyGeek's top pick for the best health insurance in Massachusetts for Silver HMO plans is Blue Cross Blue Shield of Massachusetts. It offers an average plan rate of $822. The average maximum out-of-pocket cost for these plans is $9,450.
Silver HMO plans tend to be cheaper than other types. However, you are bound to seek medical services within the network only, except for emergencies. To see a specialist, you need a referral. HMOs are good if you want lower monthly costs and if network doctors are nearby.
We suggest the following Silver HMO plans from Blue Cross Blue Shield of Massachusetts:
MoneyGeek's top pick for the best health insurance in Massachusetts for Silver EPO plans is UnitedHealthcare. It offers an average plan rate of $873. The average maximum out-of-pocket cost for these plans is $9,450. The provider has a lower claims denial rate, meaning this is a provider for you if you are in the market for great coverage.
Silver EPO plans are popular because they are the third most common health insurance type. You usually don't need a referral to see a specialist with these plans. Like HMO plans, you must stay within the network of doctors unless it's an emergency. This ruling, however, can limit your choices for health care services.
We suggest the following Silver EPO plan from UnitedHealthcare:
When purchasing health insurance in Massachusetts, finding the best plan for your needs and budget is crucial. Here are two key factors to consider when shopping for a health insurance plan.
Understand when a health insurance plan will cover you
Health plans often have networks, which are lists of doctors and hospitals that have an agreement with the plan. If you use these in-network health care providers, your plan pays more of the cost. If you go outside the network, the plan pays less, and you pay more out of your own pocket. Different plans have different rules about networks.
Some plans in Massachusetts let you use doctors outside their network, but you might pay more. Other plans won't pay if you go outside the network, so you must stay within it to cover the costs. Massachusetts has one EPO plan and nine HMO plans available.
Weigh the cost of premiums vs. the cost of care
Finding the right health insurance is finding the right balance between monthly premiums and the annual health care cost you have to pay, also known as the MOOP.
Some plans have low monthly payments, but if you need medical care more often, you might have to shoulder hefty out-of-pocket expenses before your insurance pays. If you pay more each month, you might have to spend less if you get sick a lot.
The Silver plan called "HMO Blue Basic II" from Blue Cross Blue Shield of Massachusetts has a maximum out-of-pocket cost of $9,450. This plan charges a monthly premium of $822. When you compare this to other Silver plans from the same company, this plan's monthly price is higher. But if you need health care services more often, this plan could save you money because the most you would have to pay is $9,450.
If you are a Massachusetts resident over 65 or have a qualifying disability or illness, you may be eligible for Medicare. This is a federal government program assisting with certain medical services. Although some form of payment may still be required, the program covers the following services:
Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you find better options.
The best health insurance in Massachusetts for 2024 is provided by Blue Cross Blue Shield of Massachusetts. However, the best choice for you will depend on your unique circumstances and needs.
A plan with reasonable prices and sufficient coverage is what you should be looking for. Despite offering reduced prices, some plans and companies might only offer a few services that may not suit all your medical needs. Your unique needs will determine what the best health insurance plan for you is.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
