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This is another installment of a new series on how to navigate life in New Bedford. Ask us your questions here and our reporters will look into it for you.
Massachusetts requires residents to have health insurance, and for many, MassHealth and the Heath Connector have been lifelines. After a year of confusion and uncertainty around federal funding, the Commonwealth’s answer to Medicaid and its state-run insurance marketplace remain vital resources for many. Open enrollment for the Health Connector began Nov. 1 and ends Jan. 23.
To be eligible for MassHealth, an applicant must be a resident of the state who meets certain financial thresholds, relative to the national poverty level. For a family of four, the national poverty level is $32,160 in yearly income. However, these thresholds vary, depending on who lives in the applicant’s household, and people with income up to 400% of the federal poverty level can be eligible for MassHealth.
Have questions about how to navigate life in New Bedford? Ask us here and our reporters will look into it for you.
The Health Connector is a state-run insurance marketplace open to anyone who does not receive insurance coverage through their employers. Some of these plans, called ConnectorCare plans, are subsidized, with discounts available to households with income below 500% of the federal poverty level.
During the Health Connector’s open enrollment period, Massachusetts residents can change their health insurance coverage plan for any reason. Outside of this period, residents must have a “qualifying event,” like a new employment or marital status. So, between Nov. 1 and Jan. 23, policy holders and applicants can compare plans at masshealthchoices.com, and decide what’s right for them.
Those in a MassHealth coverage type where they can enroll in a plan have a similar open enrollment period, called the Plan Selection Period, at the beginning of each year for 90 days.
Despite confusion around federal changes to Medicaid, Carl Alves, chief executive director of Positive Action Against Chemical Addiction, encourages everyone in need of health insurance to apply for MassHealth.
“There’s this level of confusion, just because nobody thinks that it’s going to be the same as it was, but they don’t know what the future holds,” Alves said. “It’s really important not to just take it for granted, but see it for the importance that it deserves.”
Here’s what you need to know about both programs.
Who can enroll in MassHealth?
To apply for MassHealth, you must be a resident of Massachusetts who is financially eligible.
Your financial eligibility is determined by the size of your household, and the amount of income you receive. See specific guidelines on this here.
2025 MassHealth Income Standards and Federal Poverty Guidelines (click to expand) ↓
MassHealth offers different types of coverage for eligible people, and levels of coverage depend on different circumstances, including if you are:
- Younger than 19 years old
- A young adult 19 or 20 years old
- An adult 21 through 64 years old
- A parent living with your children, who are under 19 years old
- Pregnant
- Disabled
- HIV-positive
- A breast or cervical cancer patient
For people over 65 years old, there are different options, including Medicare, MassHealth, and Senior Care Options, which combines the two. See eligibility criteria here.
How can I apply for MassHealth
You can apply for MassHealth online, by mail, by fax, by phone or in person, although MassHealth customer service representatives recommend applying in person if you think you’ll have questions.
To apply, you may need to provide the following for all members of your household:
• Social security numbers
• Federal tax returns
• Information about citizenship or national/immigration status
• Employer and income information
• Information about job-related or other health insurance you have access to.
If you cannot provide information about your immigration or citizenship status, it may impact the level of coverage you receive from the state.
The biggest tip MassHealth customer service representatives give for applying is to have all of the documentation you might need readily available.
Alves said enrolling in MassHealth requires follow-through, which can be difficult for people who are struggling with their mental and physical health. After submitting a MassHealth application, it’s likely you’ll have to complete additional steps.
The state will contact you if you need to provide more information, and the decision about your eligibility will arrive by mail. However, if you apply online or by phone, you will get information about any further information needed when your application is complete.
Once you’re determined to be eligible, you will need to enroll in a health plan.
If you’re overwhelmed or uncertain about getting every step of the process done, Alves has one piece of advise:
“Ask for help,” he said. “A lot of treatment agencies can help guide people through that process … it’s not something that you can be passive about.”
MassHealth has a customer service help line, which you can call at (800) 841-2900. Application aids and services are available to people with disabilities through the MassHealth Disability Accommodation Ombudsman.
If you’re not eligible for MassHealth, but need coverage, that’s where the Massachusetts Health Connector comes in.
What to look for when choosing a plan on the Health Connector
The Massachusetts Health Connector is a marketplace of insurance plans by nine licensed carriers for people who don’t receive insurance coverage through their employers. The Health Connector is state-run and allows people of any income level to buy health insurance. It also offers discounted plans for people whose income is below 500% of the federal poverty level.
The Connector is designed for people who do not have health care coverage through an employer and are not eligible for MassHealth. You can qualify for the Health Connector at any time of year if you experience a qualifying event, and without a qualifying event during open enrollment.
You can apply to the Health Connector online, and after applying will need to submit eligibility verification documents, such as a driver’s license, school identification card or permanent resident card.
Every Health Connector plan includes essential health benefits, free preventive health services, coverage for pre-existing conditions and pregnancy, maternity and newborn care. Be sure to confirm that the health care providers you use accept the insurance plan you’re considering.
The state advises you to always look for disclaimers on the website or policy documents such as “this is not insurance,” or “does not meet Minimum Creditable Coverage.”
Plans sold on the Connector are broken down by how costs are shared, so the most important thing to focus on is what you’ll contribute, like co-pays and deductibles. The more costs you share, the lower your monthly premium will be.
Another important thing to look for is whether the health plan you’re considering requires “prior authorization.”
Prior authorization gives the health care provider the ability to decide if care is medically necessary, safe and cost effective, according to the state’s website, though this does not apply to emergency care.
Abigail Pritchard, a graduate student in the Boston University journalism program, is a frequent contributor to The New Bedford Light. She can be reached at apritchard@newbedfordlight.org.
Editor’s note: This story was modified on Tuesday, Nov. 4, 2025, to clarify the open enrollment period for MassHealth, which is different from the Health Connector open enrollment period. MassHealth enrollment is year-round.
