A Guide for Individual Massachusetts Artists Working in all Disciplines and for the Self-employed to Navigate Massachusetts Health Care Reform (aka the Don't Panic Guide)

(This guide was updated 10/21/11- * indicates where the updates are in the guide)

Navigating the health care system can be daunting. It is important to take a step back and see what options are available to you and what new requirements are expected of you with the health care reform law. It is important not rush and enroll into something you cannot afford. It is also very important not to forgo medical care if you need it. The State Legislature, the Connector, health care providers, and advocacy groups are working hard to make sure that people who are uninsured and those who are struggling to stay insured are not negatively impacted by this new law. They are there to help you and need to be informed if something is not working properly with the new law, especially amongst the artists population. It critical that when you interact with an enrollment specialist and/or a staff person at a designated State agency or a designated advocacy organization that you identify yourself as an artist. Many are training their staffs to become familiar with artists' needs. Some agencies and organizations have even designated a staff person to work specifically with artists. We encourage you to print out sections from this web site to reference.

We are using a broad and inclusive definition of artists working in all disciplines. It encompasses- visual artists, musicians, composers, writers, poets, film makers, playwrights, new media artists, crafts people, actors, singers, performance artists, graphic designers, lighting designers, dancers, choreographers, and the like.

We are monitoring and advocating for the artists population on the health care reform law and we need to know what is working and what is not working with the law implementation and the new health care options. Several artists across the state have been alerting us to problems they have encountered and as a result we have been able to fix these issues not only for the those artists, but we have also been able to work to fix the issues "through out the system". Please email us if you have or are experiencing difficulties or have had a good experience for that matter. All the information is kept confidential. Email us: feedback@healthcareforartists.org-- Also see our contact info as well.

As mentioned in the basic information section of this web site, beginning of July 1, 2007, residents of Massachusetts 18 years of age and older are required to have health insurance that is deemed affordable to them at their income level (Note one must have proof of health insurance and they will file it with their State Income Taxes-either with a what is called a HC-1099 or a copy of their health insurance card/plan). This is referred to as the "Individual Mandate" and we recommend that you print out that section. Also in that section are links to the online tools that can help you determine if you are exempt from the Individual Mandate. - PLEASE remember that the test is one's ADJUSTED GROSS INCOME for the mandate and one can appeal the fines (the Connector does not make that clear on their website) (see our FAQ section for more info on the 2011 tax fines).

By January 1, 2009, you will need to verify that your health insurance meets the State's "minimum creditable coverage" standards for Health Insurance. These standards have been finalized and we have a section on those requirements and what health plans are exempt from those requirements. Also there are changes that have occurred to what was called "the Free Care Pool" that often covered the medical expenses of low income people. It is now called the Health Safety Net and there are new eligibility requirements and new restrictions in place.

A message from the Connector (aka The State Agency-Commonwealth Health Insurance Connector Authority):

"The Connector is not interested in penalizing people, wešre interested in insuring them. With that in mind, we understand the issues at hand regarding enrollment efforts and penalties for those still trying to get into a plan. We encourage all individuals to continue to apply, enroll in a plan, and pay their initial premiums as soon as possible. As things stand now, there is a robust appeals process that has been put in place that will take those situations into consideration, and other options are being discussed."

*PLEASE be aware that the rules for when someone can purchase insurances as an individual on the private market has drastically changed. There is now an annual open enrollment period and if you miss that enrollement period and you do not have what is called a "qualifying event"- you can't buy insurance! More on this in the issue on this page and what you can do: Private Insurance Rules.*

Also the Connector has Young Adult Plans (YAP) for those who are 18-26 years of age. The YAP plans can only be purchased through the Connector. Please make sure you read our buyer beware information on the YAP Plans in our Health Care Options Available section of our Guide for Artists. Note the same applies on the YAP plans as it does in the private insurance market place see: Private Insurance Rules.*

As an individual you will need to know the following:
How to define your income and how to prepare for interacting with an enrollment specialist. *
The health care options available to you from health care reform and the existing health care options *
What a Section 125 Cafeteria plan is and the pros and cons of it
Key information about Minimal Creditable Coverage (MCC) requirements *
What you need to know about the Health Safety Net (HSN) formerly known as the "Free Care Pool"

Plus there is important key information for those with multiple part-time jobs (even if they are seasonal or temporary and you get a W-2 for them) and/or those who are independent contractors

How to prepare for interacting with an enrollment specialist.

Please read through the above information sections before picking from the below scenarios:
You currently have insurance *
You currently do not have insurance *
You are currently unemployed or are going to be in the very near future *
You are in danger of becoming uninsured in the near future
You are planning on staying uninsured

You are going to be graduating or have recently graduated from High School or College or you are taking a semester off or you will be uninsured in between academic years
(i.e. you don't have health insurance lined up after you graduate, or the job you have lined up does not offer you insurance, or the job you just got and will offer you insurance doesn't start for a couple of months, etc..) *
You uninsured and are not a Massachusetts resident You do not file MA state income taxes but you are currently residing in MA - i.e. you are an out of state student, a visiting artist or you are commuting to your job in Massachusetts but live out of State and you may be staying multiple days in MA as part of your commute (i.e. you teach Mon-Wed in MA).
You currently have medical debt, credit card medical debt, or I am having trouble paying my medical bills, and/or I need legal assistance

Special information for current college/university students

Special information for immigrants

Again we must stress that the information on this web site should not be used in replacement for talking to an enrollment specialist and/or a staff person at a designated State agency or a designated advocacy organization. It is only meant to act as preparatory information and is intended only for educational purposes and is not meant to be legal and/or tax advice.

NEXT STEPS- after reading the above information *