How does the Mass. health care system work??

Just wondering as the US goes toward universal health care. a lot of people are talking about the Massachusetts system.  You don't need to go into a huge explanation...just was wondering how it works.  Also what do you like and dislike about the system there.  Thanks, Brian in CA

Here's what I know (ok, it's not much):

When the laws changed in MA for health care, NOTHING about my health insurance changed.  I am employed by a university, and I get my health insurance through them.  I pay some, they pay some. 

Those who are not offered health insurance through their employers have the opportunity to purchase insurance through the state.  I know others who have done this and the prices and plans are comparable to what you might get through an employer.

We also have Medicare and Medicaid available like other states.

When we file state income taxes in the spring, we get a tax form from our insurers, much like what your employer or bank sends you.  We must prove that we have health insurance on our state tax forms.  If you DO NOT have health insurance of any kind, you are penalized.

Hope this helps!

basically, it is a program on the foundation that everyone needs insurance to keep all our costs down.  An employer over x employees cannot say "I am not giving health insurance" or that employer gets a $$penalty. Same for employees..they must have some type of insurance or they get penalized$$ as well.
The plan is managed by the state currently, but private companies are providing the insurance. The state already knows it will cost more per person than expected..and they are trying to figure out how to keep the costs down..to make it palatable to the public.
here is the website:http://www.mahealthconnector.org/portal/site/connector/

The concept is good....to me..the jury is still out to model a national plan on this plan.
joan

Sounds interesting...What about preexisting conditions???  Weightloss surgery, heart, cancer...are these covered by the private companies or do they throw those people into the state pool?

the private companies actually is the insurance company.   The facilitator of the program is the State.  I don't know about pre-existing..but I think under the spirit of the program there wouldn't be exclusions for heart, cancer, etc.  Under one state program(medicare) they require the 6mos supervised visits.  One issue patients have been finding is that not all docs take the the insurance...so people might need to travel outside of their community to find a specialist they may need.  And, in Eastern Mass..primary care doctors are at a shortage anyways.  But, even with this connector....if people go to the emergency room...the hospital will get paid versus in the past the hospital had to eat the cost  for the uninsured/indigen.
Joan

also the state-sponsor medicare/medicaid is on a sliding scale.  if you are below a certain income threshold you get it for free.  and it's a pretty good plan from what i've been able to see.  our oldest kid, who is very young adult and supporting himself, has no employer insurance, gets free insurance, pays $2 for prescriptions, and has dental and vision coverage.  He has better insurance than we do.

While i'm a solid fan of universal health care, i do not find this equitable.  we pay a small fortune out of pocket to insure our family, and pay taxes on top of that to insure other people, some of whom genuinely need the help, and some of whom just take advantage of the system.  i don't mind paying taxes (i don't enjoy it, but i see the need) but we should ALL have the same coverage and the same out of pocket health care costs, especially working people who are bearing the brunt of all the expense for both ourselves and those in need. 

with my husband's employer paying 80% of our health plan (which is a generous allotment, many people are only getting 50-60% covered by their employer, ironically many of them employed in hospitals and other healthcare agencies), we still pay $170 a week to cover my DH, myself, and our daughter.  Plus $15 copays, plus easily 10, 20, or 40 dollar copays for prescriptions (and most prescriptions we have gotten are not in the $10 tier).  We easily pay $800 a month in *preventative* health care alone.  That's with my husband making between 50-60k a year and me working sporadically since the dot.com crash in 2002.  With rents around here over 1k for a 1 bedroom (our mortgage is double that, but we have rental income), and groceries and oil having tripled in cost the last 8 years, while our salaries remain frozen or reduced, this version of health care is a serious burden.  What it is, is the old system, "plus" some hodge-podged additional policies to cover the desperately low-income and uninsured.

in my opinion we need true universal health care, one system for all citizens, like they have in the UK and some other countries (denmark?  switzerland?  sorry, i'm that ignorant), to be equitable.

you are right on about the cost of health care has so risen. 
20-12  years ago when I worked for GE, they were self insured...I paid $1. week for my own coverage.When I had the kids..I put the kids on my plan and paid 25 x 26 times a year. My husband carried his own..for GE would charge a surcharge premium if a spouse had avail insur..and the surcharge was more than his indiv.insurance.   Then I changed jobs...in 03...my employer paid the entire family plan on his dime, then two years later to 200 per month. Still very good. Then 3 years ago he went 50/50...and I pay 450 month for the family plan insurance.
so in twelve years..I have gone from 54 per month to $450 per month...and my income did not rise in that same proportion.   Somethign does need to be fixed.

Joan

I have been on Medicare/MassHealth since I was injured about 18 years ago.  If this Health Care Reform goes into effect, you will see a lot of changes in every aspect.  The problem that Obama is not considering is that there are way too many different insurance companies in the US to begin with along with those in the AMA who do not want the change at all.  The reason health care costs are so high to begin with is that people in this country are money hungry and that when your doctor bills your insurance company, there are different standards for each one!  This is what has to be taken care of...not putting Health Care universal.  You need to confront the root of the problem which is the insurance companies by having set standards for billing and payouts back to the doctors.  Also, the doctors and hospitals need to re-evaluate their needs and have set standards for care.  This has been a problem for the last 40 years and it is getting worse.  This is what I see if Obama revamps the Health Care...Increased taxes by 45% to offset the cost of getting the program off the ground and to keep it running; Not cutting areas in the government which should be cut; Social Security being eliminated because of this health care reform (how are the elderly and disabled people suppose to live??); Medicare being eliminated (again...How are the elderly and disabled suppose to get health care??); All state and local medical programs being elimiated (now how are the low income people suppose to have health care??)

As it is right now...if you are on MassHealth...Do you know how the state gets paid back??  I will tell you.  When the person who is on MassHealth dies and they have assests or equity, the State walks in and takes it all for payment of medical bills over the years in which that person has been on MassHealth!!  This is before there is any inheritance given to your next of kin!!  If you own a house, they take it!!  You own a car...they take it!! 

The Massachusetts system of health care is always getting the shaft and being played with.  We have a Governor who set his State Budget around casino income which we don't even have!!!  This puts the State in the red and what gets cut first??  Health Care!!  As it is right now, the health care for MassHealth adults has been cut drastically...We have NO MORE dental care--AGAIN!!  NO MORE vision care--AGAIN!!  Prescriptions are going up from Free to now $5.00 per...I could go on and on and on for I see the results from the eldery end and the disabled end of the spectrum.  

I hope this enlightens everyone here who did not know about the system so far.

--L. C. in MA

We know there is no free lunch...esp with states having to ballance their budgets.  How did you pay for your RNY?  I had two insurance companies...neither paid for mine.  I had to chuck out $23,000. for it.  Do it or die...Not much of a choice.