You are going to be graduating or have recently graduated from High School or College and you don't have health insurance (or you do not have a job lined up that will offer you insurance, or the job you just got doesn't start for a couple of months, etc..) or you are taking a semester off from college and/or you will be uninsured in between academic years (i.e. you can't purchase your college/university health plan during the summer months because you are not taking classes).
The first thing you need to understand is "individual mandate" and what it means (we recommended you print out that page).
Beginning on July 1, 2007 all Massachusetts residents over the age of 18 are required to have health insurance coverage or they risk being fiscally penalized on their 2007 State income taxes by losing their personal exemption, if the individual has had health insurance available to them that is considered affordable at their specific income level by the state. In 2008 and beyone there are different penalties for those not having health insurance coverage. The Massachusetts Department of Revenue (DOR) will be policing this part of the law.
TWO IMPORTANT WARNINGS*
1) We strongly recommend that artists who have hard to determine income DO NOT enroll or sign up for any program/health insurance plan via the Connector's website or phone lines. Only use the Connector as a way to research your options. This is very important. It is best if you talk to a seasoned enrollment specialist from Health Care For All's Help Line or an enrollment councilor from a Community Health Center, a hospital, or a health care advocacy organization to see if you are first eligible for a subsidized health plan and if you find out that you are not eligible THEN use the Connector to enroll in a non subsidized health plan (i.e. Commonwealth Choice plans). UNTIL THE ISSUES THE AF HAS IDENTIFIED WITH THE CONNECTOR'S ENROLLMENT PROCESSES ARE CORRECTED, IT IS BEST TO FOLLOW THIS PATH.
2) NEW Private Insurance Rules- don't miss a payment or get dropped from your insurance plan if you are buying it 100% yourself!
IN 2010 the insurance companies convinced the state legislature that people in the private insurance makret were "gaming the system" and causing the insurance companies to lose money. So the state legislature changed the law governinng when and under what circumstances individuals can buy insurance in the private market place. No advocates were consulted on this change before it became law. This new law did not change the rules for those in subsidized care, or how businesses can buy insurance. The law only changed it for those individuals who earn over 300 percent of the Federal Poverty Line. (For the record the Artists Health Care Working and Healthcare for Artists.org were against how this change was put into place and testified against it).
There is now a strict open enrollment period and if individuals miss that period (or they get kicked off their plan) they will more than likely be locked out of buying insurance unless they have a "qualifying event". Note if your employer offers you insurance and it meets minimal credible coverage, you are not allowed to forgo your employer's insurance and buy insurance on the private market place- unless you have a qualifying event (so if you dont' like the insurance your employer is offering you is not sufficent to allow you to buy private insurance even if you can afford it). 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.
For more information and to find out what a "qualifying event is" see the Connector's PDF fact page. We also urge you to call Health Care for All's FREE Helpline for information and help: 1-800-272-4232. AND call your state representative and state senator and urge them to change this law!
You currently do not have insurance and you are NOT a Massachusetts Resident...
If you are not a Massachusetts resident and you are not planning to become one (i.e. you may stay in the state for the summer after graduation, but you are not going to file Massachusetts Income Tax forms), the individual mandate does not apply to you. Nor do any of the other requirements under this law. This also applies to immigrants and international students who are not Massachusetts residents.
What you also need to be aware of is what was called the "free care pool" that covers the uninsured medical expenses of those who are under a certain income level, has changed in name and how it operates. It is now called the Health Safety Net (HSN). From what we understand, the State will now be tying payment for medical expenses for those who are eligible for free care to if they are Massachusetts residents (only Massachusetts residents will be able to covered by the free care pool). WHAT this does not mean is that they will not deny you health care- but it may mean your medical expenses for receiving the care may not be covered by "free care pool" even if your income level would make it so. Again we strongly suggest you contact a health care advocate for more information on HSN and if you are eligible for it. Please also see our section on the HSN
If you are an immigrant (legal or illegal) there is an organization that can help you navigate visa options, citizenship issues, adjustment of status, replacement/renewal of legal permanent residency cards, etc.. The organization is the Massachusetts Immigration & Refugee Advocacy Coalition and the contact info: 617-350-5480 www.miracoalition.org
If you need legal help, contact the Massachusetts Volunteer Lawyers for the Arts: 617-350-7600
You are a Massachusetts resident and you will be uninsured as soon as you graduate from high school (turn 18) or will be uninsured when you graduate from College...
First is to understand is that individual mandate does apply to you and you will need to get insurance if you do not want to be penalized by DOR (MA Department of Revenue) on your taxes.
You have several options to consider:
If you are age 19 or older and your annual gross income is at or below 300 percent of the Federal Poverty Line, and your job is not offering you insurance, you may be eligible for Commonwealth Care if you meet the programs other requirements. (NOTE for those 18 years old: Even though you are not eligible for Commonwealth Care because of your age, you may be eligible for a Mass Health Program. So it is still worth your while to contact an enrollment specialist at the Health Care for All's Help Line or contact an enrollment specialist at your local community health center or hospital.)
(300 percent of the FPL for an individual is approximately $32,676 (NOTE every April 1- the FPL amount will increase/be adjusted) and to find what 300 percent FPL for a family is, add an additional $11,460 for each additional dependent to amount for an individual (see the Insurance Partnership's web site for a better understanding of the FPL which is also referred to as income ceilings).
However, annual gross income for those who are self-employed, seasonal workers, don't have regular pay stubs, and/or have combination income sources (W-2 income, 1099 income, etc.), is determined differently from those with just W-2 income wages with regular pay stubs. Those whose income is not solely from W-2 income sources with regular pay stubs, should contact an enrollment specialist in person to determine what their income is.
If you are under 26, you may now be able to purchase insurance through your parent(s) health plan due to the Dependent Coverage Extension Requirement, taking effect on Jan 1, 2007.
If you do not have a job or are still looking for one and don't have any income or the income you have is at or under 300 percent of Federal Poverty Line, you may be eligible for Commonwealth Care or a Mass Health Program.
If you are in a waiting period for your first after high school job or are waiting for your first after college job to start (say it doesn't start until the fall and you have a summer job with out insurance), and your income is at or under 300 percent of Federal Poverty Level, you may be eligible for Commonwealth Care or a Mass Health Program.
If your first job after high school/after college job has a waiting period for you to get insurance (i.e. you have to wait 90 days before you are eligible for insurance through your employer), and your income is at or under 300 percent of Federal Poverty Level, you may be eligible for Commonwealth Care or a Mass Health Program.
You may want to see if the Commonwealth Choice Plans (available to those who are age 18 and older) or if the Young Adult Plans (available for those who are 18-26 yrs. old-Note it used to be 19-26) are choices for you. A buyer beware on the Young Adult plans. Like the student health insurance plans offered by colleges/universities to students, all of the YAP plans, with the exception of the Blue Cross Blue Shield Young Adult Plan, have an annual limit on benefits or benefit caps on the amount they will pay out per year for coverage (i.e. they may only cover a total of $50,000 worth of medical bills per year and after you hit that amount you are responsible for the bills). Make sure you know what you are buying and what the YAP covers and what its benefit cap is before you buy it. AGAIN be aware of #2 in the warning section.
You could join an association or membership group to that offers its members the ability to purchase insurance through a group rate. The Insurance Partnership has a list of organizations who offer their members access to health insurance.
You could decide to purchase your health insurance as an individual through an health insurance compan, but be aware of #2 in the warning section.
You are a Massachusetts resident and you will be uninsured in between academic years (i.e. you can't be in your college/university health plan during the summer months because you are not taking classes) or you are taking a semester off and will not be able to purchase health insurance through your college/university...
If you are under 26, you may now be able to purchase insurance through your parent(s) health plan due to the Dependent Coverage Extension Requirement, taking effect on Jan 1, 2007.
If you are enrolled in the a student health insurance plan your university/college offers, check to see how long the health coverage goes for after the end of a semester (i.e. some cover you for up to two months after a semester ends).
If you do not have a job or paid internship for the summer, are still looking for one for a job/internship and you don't have any income, or the income you have is at or under 300 percent of Federal Poverty Level, you may be eligible for Commonwealth Care or a Mass Health Program. (Note if your employer offers you insurance and pays 33 percent of your plan, you will not be eligible for Commonwealth Care)
You may want to see if the Commonwealth Choice Plans (available to those who are age 18 and older) or if the Young Adult Plans (available for those who are 18-26 yrs. old- Note it used to be 19-26) are choices for you. {A buyer beware on the Young Adult plans: Like the student health insurance plans offered by colleges/universities to students, all of the YAP plans, with the exception of the Blue Cross Blue Shield Young Adult Plan, have an annual limit on benefits or benefit caps on the amount they will pay out per year for coverage (i.e. they may only cover a total of $50,000 worth of medical bills per year and after you hit that amount you are responsible for the bills). Make sure you know what you are buying and what the YAP covers and what its benefit cap is before you buy it.} AGAIN be aware of #2 in the warning section.
If you are sick do not forgo care because you do not have insurance or due to your immigration status! We highly recommend that you locate the Community Health Center or Hospital in your neighborhood and go to them for care.