We are a comprehensive health plan founded in 1997 to improve access to affordable health care in Massachusetts. At that time, we were contracted by the state to offer MassHealth, a state- and federally funded program designed for Massachusetts residents with low incomes.
In 2006, Massachusetts passed a health care reform law that requires nearly all residents to have health insurance coverage. In response, Massachusetts expanded its Medicaid program to include Commonwealth Care, an additional state- and federally subsidized program designed for Massachusetts residents 19 years or older who earn at or below 300% of the federal poverty level. We were among the first Medicaid managed care organizations (MMCOs) to receive a contract from the state to offer this program.
We became a Tufts Health Plan subsidiary in 2011.
In 2012, we partnered with the Department of Unemployment Assistance to administer the Medical Security Program Direct Coverage Plan, a state-subsidized program for Massachusetts residents receiving unemployment insurance, and their families, who earn at or below 400% of the federal poverty level.
In 2013, we entered the commercial health insurance market by offering Commonwealth Choice, a state program providing unsubsidized health insurance to Massachusetts residents.
Also in 2013, we began participating in a new joint state and federal pilot program serving adults with disabilities aged 21 – 64 who are eligible for both MassHealth and Medicare. This initiative, called One Care, integrates Medicaid and Medicare benefits and services, providing those eligible with coordinated high-quality and cost-effective health care.
In 2014, under the Affordable Care Act, we began offering Qualified Health Plans (QHPs) for individuals and families who are not eligible for employer-sponsored insurance, and employer groups with 1 – 50 employees.
Today, we are:
- One of five MMCOs contracted by the Commonwealth of Massachusetts to provide health care coverage for the state’s MassHealth population
- One of three One Care plans serving the One Care population
- One of 12 QHPs serving the QHP population
For these plans, we offer services in more than 300 cities and towns in Massachusetts.