There are different health insurance options available for individuals with disabilities in Massachusetts. BenePLAN can help you access the right health insurance for you.
Medicare is federal health insurance provided to individuals who are 65 years or older, under age 65 and disabled or who have collected Social Security Disability Insurance (SSDI) for two years. It is also available to individuals with end stage renal failure prior to age 65. It consists of four parts:
Part A – Hospitalization
Covers services including medication provided while in the hospital. There is no monthly premium.
Part B – Outpatient Services
Covers doctor’s visits, physical therapy, clinic visits and psychological services. There is a monthly premium cost.
Part C – Medicare Advantage and Medigap Policies
These are private insurance policies that you can purchase to help cover co-pays and deductibles, as well as providing additional coverage to your Medicare.
Part D – Prescription Drug Coverage
Provides coverage for prescription drugs; policies are provided by a a large number of private insurers, and are purchased by you.
Medicare coverage can continue for up to 93 months when an SSDI recipient stops receiving a monthly check due to work activity.
Medicaid, MassHealth, & MassHealth CommonHealth
Medicaid in Massachusetts is called MassHealth and has a number of different programs that will allow you, if you are eligible, to access high quality health care in Massachusetts. These programs include:
MassHealth Standard, a state funded health insurance program for individuals with disabilities who receive Supplemental Security Income (SSI). It is also available to individuals with disabilities receiving SSDI whose income is low enough to make them financially eligible. There is no monthly premium for this insurance.
MassHealth CommonHealth, a Medicaid Buy-In program that provides health insurance to individuals with disabilities who are working and whose income is too high to be eligible for MassHealth Standard. CommonHealth provides the same high quality level of coverage as MassHealth Standard. To be eligible for MassHealth CommonHealth, an individual needs to be working 10 hours or more per week or 40 hours or more per month, or have worked 240 hours in the previous 6 months. Unlike MassHealth Standard, MassHealth CommonHealth does charge a sliding scale monthly premium based on income.