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Healthcare is so broken in the US. I'm trying to fix it.

  • The government knows more about you than you do.

In Massachusetts, health insurance is mandatory - or you will be fined when you file taxes. Of course everyone wants healthcare, so on the surface it's not too onerous to say that it's "mandatory". But, if you're not covered by an employer plan (self-employed, small employer, laid off), then you must obtain health insurance on your own. It is rather insane to tie health benefits to employment when employment changes routinely - whereas healthcare is something that you want to be continuous, permanent, and stable over time.

MassHealth

MassHealth overview
Overview of MassHealth

To obtain your own healthcare insurance, you can get it through Medicaid and/or the Children's Health Insurance Program (CHIP) if you qualify. Both of those federal programs are known at the state level as MassHealth. Although these are Federal programs, they are run and administered at the state level and so costs are different in each state.

One of the nuttiest things about MassHealth is that you can get some services through MassHealth (e.g. long term services and supports; behavioral health like psychological study) that are not available through commercial insurance. So, you can find yourself trying to qualify for Medicaid or CHIP just to get services you desperately need - but get denied or find the process so lengthy and complicated that it doesn't serve the need. Getting these services at all can be extremely difficult, very expensive and definitely complicated and delayed. This is why so many kids have "meds" - it is super expensive (thousands of dollars out of pocket if you can find the service) to figure out what might be going on in your adolescent child's developing brain, but super easy to get a prescription and "see what happens".

Health Connector

Whether or not you qualify for health insurance under Medicaid and/or CHIP, you may also need to obtain health insurance through a health insurance Marketplace. In Massachusetts, that marketplace is called Health Connector. Note: small employers with less than 50 employees can offer health and dental plans through 'Health Connector for Business'.


All these programs are combined in Massachusetts under https://mahealthconnector.org


In order to determine eligibility (every year)


  • Your hospital and doctors know more about you than you do.