How to Sign Up for ACA Health Insurance in Massachusetts

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• Key dates: Open enrollment runs from Nov. 1, 2023 through Jan. 23, 2024.
• Where to apply: Massachusetts Health Connector, the state’s Affordable Care Act (ACA) marketplace
• What’s changed: The ConnectorCare program — which offers plans with low or no premiums, no deductibles and low out-of-pocket costs — is being expanded, starting Jan. 1, 2024.

Most Massachusetts residents, including non-U.S. citizens with worker or student visas, are eligible to buy health insurance through Health Connector.

Depending on your income, you may qualify for free or low-cost options such as ConnectorCare or MassHealth, which combines Medicaid and Children’s Medical Security Plan (CMSP) enrollment. Certain low-income residents may also be eligible for a Health Safety Net (HSN) plan, which covers costs related to hospital and community health center care.

• Open enrollment for 2024 coverage runs from Nov. 1 through Jan. 23, 2024. 

• You can enroll anytime if you qualify for a MassHealth plan, Children’s Medical Security Plan, or ConnectorCare plan. You also can enroll at any time if you’re applying for dental coverage or if you’re a member of a recognized American Indian tribe or an Alaska Native. 
  
  
• You can apply for Health Safety Net at any time throughout the year, but if you have ConnectorCare, you must apply for Health Safety Net no later than 90 days after the date on your ConnectorCare application.

• You can enroll in a new plan or change plans once per month if you are eligible for ConnectorCare and your income is no more than 150 percent of the federal poverty level. For example, an individual who earns up to $21,780 or a family of four that earns up to $45,000 annually qualifies for this special enrollment period.
  
  
• If you have lost MassHealth coverage because of the federal government’s ending of pandemic-era Medicaid rules, you may still be eligible to renew your coverage. Contact MassHealth at 1-800-841-2900 for more information.

If you don’t qualify for year-round enrollment and missed the open enrollment deadline (Jan. 23, 2024), you can buy health insurance if you experience a life event that qualifies for a special enrollment period. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances, including the loss of MassHealth coverage. You typically only have 60 days from that event to enroll. For more information, call 1-877-623-6765.

You also can request an open enrollment waiver that allows you to enroll in health insurance without a qualifying event. More information is available online through the state Office for Patient Protection.

The income limits for ConnectorCare will increase and all major insurance carriers, including United HealthCare and Blue Cross Blue Shield of Massachusetts, will be included in the program starting Jan. 1, 2024.

ConnectorCare is expanding its eligibility from Massachusetts households who earn up to 300 percent of the federal poverty level to those who earn up to 500 percent of the federal poverty level. This means that individuals whose annual income is no more than $72,900 or a family of four whose annual income is no more than $150,000 now can qualify.

Find more information about these changes at the exchange’s website.

First, collect documents you may need for the application process, including your Social Security number or immigration documents and your federal tax return from last year.To apply and enroll:

• Online: Click Apply Now on the Health Connector page. You’ll be asked to create an account if you don’t already have one. You’ll also be asked for personal information like your Social Security number (if you have one), your address and proof of income. Your application will determine whether you qualify for a Health Connector, MassHealth or ConnectorCare plan, so you won’t need to submit separate applications.

• By phone: Call 1-877-623-6765. If you’re deaf, hard of hearing or speech disabled, call 1-877-623-7773.

• By mail: Mail a completed application to:
  Health Insurance Processing Center,
  P.O. Box 4405
  Taunton, MA 02780

Online applications are typically the fastest way to get coverage, but you can also apply by phone or mail. Or you can visit a Health Connector walk-in center in Boston, Springfield or Worcester. If you need help with your application, check Health Connector’s guide to enrollment or call 1-877-623-6765 to speak with a customer service representative. Or contact a local enrollment assister or application counselor.

Once you’re approved for a plan, you’ll need to pay your first monthly premium by the 23rd of the month for your coverage to begin.

Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family.

If you qualify for Medicaid through MassHealth, you may be eligible for free or low-cost coverage, and may not have premiums or co-pays, depending on your level of income. All Health Connector plans cover 10 “essential” benefits, including:

• Emergency services and hospitalization 
• Pregnancy, maternity and newborn care 
• Mental health services (including counseling) 
• Chronic disease management
• Pediatric care 
• Prescription drugs 

Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family. Dental plans are available for children under 19, families and individuals, and you can add them to your existing plan or enroll at any time of the year. Deductibles and out-of-pocket costs vary between plans. Children’s plans cap out-of-pocket expenses at $350 and cover medically necessary orthodontia. To purchase a dental-only plan, call 1-877-623-6765.

Massachusetts Health Connector’s plans are organized into four categories:

• Bronze plans have the lowest monthly premiums and the highest deductibles and copays. They cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury. 

• Silver plans have moderate monthly premiums, deductibles and copays. They cover roughly 70 percent of costs. They’re the only plans eligible for cost-sharing subsidies. 

• Gold plans have higher monthly premiums and lower deductibles and copays, and they cover roughly 80 percent of care costs. 

• Platinum plans have the highest monthly premiums and the lowest deductibles and copays. They cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums. 

You can compare plans and estimate costs using the Health Connector website, but you’ll need to complete an application to see whether you qualify for tax credits or other financial assistance. Massachusetts residents under 30 can also apply for a catastrophic plan offering low premiums but with very high deductibles.

The federal government increased tax credits for insurance premiums in 2021 and expanded the number of households that qualify for them. As a result, most people enrolled in ACA marketplace plans have seen their premiums go down. This expanded financial assistance is available through 2025.

• If your annual income is below 150 percent of the federal poverty limit ($21,870 in 2024 for an individual and $45,000 for a family of four), you may be eligible for zero-premium coverage, depending on the plan you choose.

• If your income is between 150 percent and 400 percent of the federal poverty level (up to $58,320 for an individual and $78,880 for a couple) you are eligible for a premium subsidy. The amount depends on your income and your plan.
  
  
• If your income exceeds the above limits, you can still get a premium subsidy if your monthly charge for the most popular silver-level plan would be more than 8.5 percent of your income.

If you’re eligible, Massachusetts Health Connector will automatically apply the credits when you enroll.

Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.

The MassHealth Premium Assistance (PA) program reimburses some or all of the premium costs for people with certain types of employer-provided health plans. Eligibility varies based on household income and several other factors, including disability status, the presence of children in the home and the type of plan offered by the employer. Call MassHealth premium assistance experts to learn more at 800-862-4840.

ConnectorCare offers plans with low or no premiums, no deductibles and low out-of-pocket costs to Massachusetts households who earn up to 500 percent of the federal poverty level.

Certain residents also may be eligible for Health Safety Net, which can help cover hospital and community care center costs if your household is at or below 300 percent of the federal poverty level — or in other words, an annual income of $43,740 per person or $90,000 for a family of four. You may still need to meet a deductible, depending on your income.

Use the marketplace website’s Get an Estimate tool to see if you qualify for savings.

If you already have affordable coverage — through your employer, for example — you most likely will not qualify for financial help offered through the marketplace plans.

If you’re independently enrolled in a private health insurance plan, not through an employer, you may qualify for significant savings if you switch to a Massachusetts Health Connector plan. But you may need to wait until open enrollment begins.

If you were receiving temporary continuation of your health care coverage under COBRA, and that coverage has ended, you may be able to sign up for a Massachusetts Health Connector plan during a 60-day special enrollment window. Try to apply and select your plan before your COBRA coverage ends to make sure there’s no gap in coverage.

If you already have a marketplace plan and want to adjust your coverage, you'll need to do so during open enrollment, unless you experience a qualifying life event or qualify for year-round enrollment.

That depends. Major insurance providers, including UnitedHealthcare, Blue Cross Blue Shield of Massachusetts and Health New England offer Health Connector plans, but not all doctors accept them. You can talk to your primary care physician to see whether he or she accepts a particular marketplace plan or search the Health Connector provider directory.

It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs such as Medicare, Medicaid or the Children’s Medical Security Plan, which is available to children in households with income too high to qualify for Medicaid but who may still need help paying for health insurance. Such families may choose to enroll separately. They may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.


This guide was updated on Nov. 3, 2023, with new information about open enrollment.

• Affordable Care Act Open Enrollment Begins Nov. 1
• ACA Subsidies Extended
• How Medicare Rx Price Negotiations Will Work
• Big Changes Coming to Medicare Part D