The Massachusetts Insurance Exchange (Marketplace) is called Massachusetts Health Connector. Massachusetts Health Connector is administered by the State of Massachusetts.
General information about the Massachusetts Health Connector can be found at: https://www.mahealthconnector.org/.
PATIENTS
Massachusetts Health Connector is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the plans in the marketplace individually in order to fully participate in Massachusetts Health Connector.
This process is similar to enrolling in insurance or managed care organization provider networks. See below for a list of insurers participating in the state marketplace, and information on contacting them.
As an HIV provider, you may qualify for the designation, of an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Division of Insurance
1000 Washington Street, Suite 810
Boston MA 02118-6200
877-563-4467
http://mass.gov/doi
Complaints: http://www.mass.gov/ocabr/docs/doi/consumer/css-complaint-form.pdf
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Massachusetts Health Connector
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Ambetter from CeltiCare Health Plan
Plan Website: http://ambetter.celticarehealthplan.com/
Provider Enrollment: http://ambetter.celticarehealthplan.com/for-providers/
Plan types offered: Individual, SHOP
Blue Cross Blue Shield of Massachusetts
Plan Website: http://www.bluecrossma.com/
Provider Enrollment: https://www.bluecrossma.com/portal/dt?provider=providerhome&usecaseid=CP45¤tMenuItem=manage_your_business
Plan types offered: Individual, SHOP
Boston Medical Center HealthNet Plan
Plan Website: http://www.bmchp.org/
Provider Enrollment: http://www.bmchp.org/providers
Plan types offered: Individual, SHOP
Fallon Health
Plan Website: http://www.fchp.org/
Provider Enrollment: http://www.fchp.org/providers/faq.aspx#howbecomeprovider Plan types offered: Individual, SHOP
Harvard Pilgrim Health Care
Plan Website: https://www.harvardpilgrim.org/portal/page?_pageid=1391,1&_dad=portal&_schema=PORTAL
Provider Enrollment: https://www.harvardpilgrim.org/portal/page?_pageid=253,1117993&_dad=portal&_schema=PORTAL
Plan types offered: Individual, SHOP
Health New England
Plan Website: https://www.healthnewengland.com/
Provider Enrollment: https://www.healthnewengland.com/HNE_Providers/contracting.html
Plan types offered: Individual, SHOP
Minuteman Health, Inc
Plan Website: http://minutemanhealth.org/
Provider Enrollment: http://minutemanhealth.org/health-professionals
Plan types offered: Individual, SHOP
Neighborhood Health Plan
Plan Website: http://nhp.org/Pages/home.aspx
Provider Enrollment: http://nhp.org/pages/contactnhp.aspx
Plan types offered: Individual, SHOP
Tufts Health Plan Network Health
Plan Website: http://www.tuftshealthplan.com/
Provider Enrollment: http://www.tuftshealthplan.com/visitors/visitors.php?sec=contact_us&content=&content=contact_us_sc&tabstate=2&WT.mc_id=provider_dropdown_contact_us&WT.mc_ev=click Plan types offered: Individual, SHOP
United Healthcare
Plan Website: http://www.uhc.com/
Provider Enrollment: http://www.uhc.com/provider
Plan types offered: Individual, SHOP