Part 2. MA HealthConnector for Freelancers
Disclaimer: This article is written primarily for freelancers reside in Massachusetts, who have access to MA HealthConnector. The content below does not represent legal or medical advice of any kind. I'm simply relating my personal experience. There's no business relationship between Feisworld and MA HealthConnector.
If you live outside of Massachusetts, a similar strategy could be applied and require you to start at Healthcare.gov (and select your zip code to get started) instead of MA HealthConnector. Benefits and process per state may differ.
Prefer listening instead of reading? Click the Play button below:
In this episode, you will learn (as a freelancer):
- How to get help paying for your health insurance
- When and how to get coverage inside and outside of the enrollment period
- What types of health and dental insurances are available to you
- How to find out If you can keep your primary care doctor on your new plan
- COBRA vs. MA Health Connector Care
Health insurance is often the number one concern for people who are considering freelancing on a full-time basis.
How much does health insurance cost? Where and how do I get it? What if I have a family?
Traditionally, health insurance is something that your full time employer sets up for you and helps pay part of the premium. It can be convenient and hassle-free. Like most people, you probably never even had to think about health insurance before freelancing.
(BTW, not all employer-provided health insurances are good. Some actually end up costing you more money - depending on the type of coverage - than if you were to seek out an alternative option on your own. That's another topic for another day.)
Contrary to common belief, health insurance is much more accessible than you think. You just need to know where to look.
Massachusetts is a good example that helps freelancers purchase individual and family health insurance easily.
Why should you consider MA HealthConnector (or Healthcare.gov) first before you go seeking out private health insurance?
"Can I get help in paying for my health insurance?"
Yes! You could get help paying for your health insurance just like when you had a full time job. It's an irresistible offer, isn't it?!
No, you or your family don't have to be living below Federal Poverty Level (FPL) in order to qualify for premium subsidy. In fact, you can earn up to 400% of the FPL and still qualify. Here's a refresher course on the basics you need to know.
Using this example below, if you have a family size of three (i.e. mom, dad, one child), you can earn up to $79,160 (net income) and qualify for subsidy.
You have to know that $79,160 is net income, not total revenue you earned for the year. Net income refers to what you earn MINUS business expenses, tax credits, etc. This concept is crucial for freelancers as we accumulate expenses to run our business throughout the year - Facebook Ads, software license, office supplies, etc. that are no longer paid for by an employer. And they really add up quickly! During my first year as a freelancer, nearly 1/3 of my revenue was spent on business expenses.
To learn more about personal and business net income calculations, read this article, or better consult with an account.
Depending on the FPL % you and your family fall under, the subsidy amount changes, so does the list of health insurance you qualify for. Another example is that "if you earn 100% of the FPL or under, and you reside in a state that did not expand the Medicaid eligibility requirements, you may be eligible for Medicaid."
What if you don't know how much you'll make as a first or second-year freelancer?
Good news - MA HealthConnector allows you to estimate your income at the beginning of the year. If you end up making more or less, you can still make adjustment by calling them up before the end of the year (and before the tax season).
For example - if you estimated $35,000 and ended up making $50,000 or more, you might need to make up the difference in payment (which is fair). If you end up making less than what you predicted, Health Connector will reimburse you. To learn more, call Health Connector directly and get an accurate response based your unique situation: 877-MA-ENROLL
Conclusion: Options are there! You have to do a little bit of work upfront. For MA HealthConnector, it's as simple as filling out a form online (click here and choose "Apply Now" to open an account) just to find out what your options are. You are not obligated to move forward with any health insurance option if you choose not to.
"When do I get coverage? What's Open-Enrollment?"
If you enroll during the regular open-enrollment period (typically between Nov 1st to Jan 31st), you can submit your application before the deadline and the coverage will begin either Jan 1st of every year once payments are clear.
If you enroll outside of enrollment period because of a life event, it may take up to 30 days (though my experience had to sooner) for you to find out if the request has been approved. Click here to learn more about response time and what to expect.
"What are 'qualifying life events'?"
MA Health Connector has a limited open enrollment. It isn't open 24/7, or 365 days of the year. However, you may qualify for a mid-year life event, or a qualifying event that allows you to enroll outside of the enrollment period.
These "events" often refer to marriage, birth, adoption, moving (to the US), etc. As a result, you may need to start a new health insurance, or add a spouse or a child to your existing plan. MA Health Connector makes it possible for life changes.
"What types of plans will I get?"
You must be wondering the types of plans and the names of the insurance companies you are applying for.
There is a "Preview Plan" option on MA Health Connector website. It's not obvious at a glance, I have indicated below via a screenshot from their homepage.
Based on your zip code, birth date, coverage start date, cover type (health and/or dental), you can preview plan options on the following screen.
To note: "Before you apply for coverage, you can see health and dental plans and prices available in your area. The premiums (costs of plans) you see do not include Advance Premium Tax Credits or other savings. You will need to fill out an application to see if you qualify for help paying for costs"
An example of available plans for a "34-year old, living in Newton, MA".
"Can I keep the same primary care doctors and services?"
This wasn't a concern for me personally, but I understand that for many families and especially people with pre-existing conditions, you want to know what you are getting into. To look up if a provider is available in your area and for the insurance you'd like to sign up for, visit: https://ma.checkbookhealth.org/ma/
"I was offered COBRA. Is MA Health Connector still an option?"
Yes. If you recently left your job or were laid off from your job, you may be offered COBRA by your employer's Human Resources (HR). COBRA is often expensive if you need to pay in full (without employer contribution).
With that said, some people prefer COBRA because it carries over the exact same insurance you had previously, for the immediate term.
However, if price is a concern, MA Health Connector is a good alternative to find out what your other options are beside COBRA.
Involuntary leave from a job often results in little to no planning on health insurance. During this stressful time and before you secure a new job, or a freelance gig to bridge the gap, MA Health Connector (or other Marketplace Health Insurance) may help lower your monthly premium for both Health and Dental insurance.
For more information about how COBRA and mini-COBRA affect your health insurance options, please contact one of the following agencies or organizations:
- Health Connector, 877-MA-ENROLL
- Division of Insurance, 617‑521-7794
- Search for a nearby Enrollment Assister (e.g. Navigators and Certified Application Counselors)
- Health Care for All, 800-272‑4232
MA Health Connector isn't perfect but it is well worth exploring for you and your family.
It took a while Health Connector adapted the paperless bills (and it's in place as of June 2017). The customer service turnaround is reasonably fast, but it certainly wasn't the case back in 2015 (my first interaction).
Let us know your thoughts, questions and how we can make this information more useful.