Medical Security Program (MSP)
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What is the Medical Security Program (MSP)?
The Medical Security Program (MSP) is a health care plan for low and moderate-income Massachusetts residents who are getting unemployment insurance benefits. This program is run by Blue Cross/Blue Shield. The MSP has two options:
-
Premium Assistance: If you had health insurance before you lost your job and can continue that coverage, the Medical Security Program will help pay for your insurance premiums.
-
Direct Coverage: If you cannot continue your previous health plan, or if you did not have health insurance, the MSP offers direct coverage for you and your family.
Your MSP coverage ends when your unemployment benefits end.
Am I eligible?
To be eligible for the Medical Security Program:
- You must be a Massachusetts resident.
- You must be getting Massachusetts UI benefits.
- You must have worked for a Massachusetts employer.
- You must meet the income limits.
If you have access to health insurance through your spouse's employer, you will not be eligible for the Medical Security Program unless you have a financial hardship.
What are the income limits?
Financial eligibility for the MSP is based on your family's gross annual income. Family income does not include the income of your dependent children.
The DUA adds your family's actual income from the 6 months before you applied for MSP, and your projected income for the next 6 months. This total annual income cannot be greater than 400% of the Federal Poverty Guidelines (FPG).
2010 MSP Income Eligibility Guidelines
(effective January 1, 2010)
Size of
Family Unit |
400% FPG |
| 1 |
$43,320 |
| 2 |
$58,280 |
| 3 |
$73,240 |
| 4 |
$88,200 |
| 5 |
$103,160 |
| 6 |
$118,120 |
| 7 |
$133,080 |
| 8 |
$148,040 |
each
additional
person |
+$14,960 |
What is a hardship waiver?
If you can continue with a previous health plan, but you cannot afford your share of the premium cost, you can get MSP direct coverage if you qualify for a hardship waiver. There are two ways to qualify:
-
You qualify for a hardship waiver if your family's gross annual income is less than or equal to 150% of the Federal Poverty Guidelines (FPG):
2010 MSP Hardship Waiver Guidelines
(effective January 1, 2010)
Size of
Family Unit |
150% FPG |
| 1 |
$16,240 |
| 2 |
$21,855 |
| 3 |
$27,465 |
| 4 |
$33,075 |
| 5 |
$38,685 |
| 6 |
$44,295 |
| 7 |
$49,905 |
| 8 |
$55,515 |
each
additional
person |
+$5,610 |
-
You might also qualify for a waiver if your income is greater than 150% FPG, but you have very high monthly expenses. You must submit proof of your expenses and a copy of your group health insurance coverage (COBRA) letter from your former employer. The MSP will review your case and let you know.
You can use the Hardship Waiver Monthly Expenses Form (PDF) from Community Partners, or another form, to list your expenses.
What benefits will I get?
-
Premium Assistance: The MSP will pay 80% of your insurance premiums, up to the payment limit. For 2010, the payment limit is $1110/month for a family plan and $450/month for an individual plan.
If you also qualify for the Economic Stimulus Plan federal COBRA subsidy, your premiums will be even less. See COBRA subsidy for more information.
-
Direct Coverage: You will get comprehensive health care coverage from the Network Blue Options Deductible health plan from Blue Cross Blue Shield of Massachusetts. The plan includes hospital care (inpatient and outpatient), doctor services, maternity care, X-rays and lab tests, well-baby visits, routine exams, family planning services, mental health and substance abuse treatment, speech therapy, home health care, and prescription drugs. There are no dental benefits.
There are co-payments and deductibles for certain services. Service providers are divided into tiers, and the amount you pay depends on which service providers you use. See Understanding Your Plan for an explanation of the tiers and costs.
The MSP service area includes all cities and towns in Massachusetts. The plan does not provide coverage outside of Massachusetts except for limited out-of-state urgent care or emergency care.
You must choose a primary care physician (PCP) to manage your care. For help choosing a doctor, call the Physician Selection Service at 1-800-821-1388.
For more information about direct coverage benefits, see Medical Security Program and Network Blue Options Deductible Summary of Benefits on the Blue Cross Blue Shield of Massachusetts web site.
How do I apply?
Once you file your claim for unemployment insurance benefits, Blue Cross/Blue Shield will automatically send you an application for the Medical Security Program. If you do not get this application in the mail within 2 weeks after you file, or if you have any questions, call the Medical Security Program Customer Service office:
- MSP Customer Service
Telephone: 1-800-908-8801
TTY/TDD: 1-800-522-1254
Hours: Monday through Friday, 8:30 AM to 4:30 PM
You can also download the application from the DUA web site:
You should file your application as soon as possible. Be sure to enclose copies of the four most recent pay stubs for you (and your spouse, if married). Blue Cross/Blue Shield will notify you within 10 business days to let you know if you qualify for coverage.
What should I do if my unemployment benefits end?
If your unemployment benefits end, you lose your eligibility for the Medical Security Program. Your coverage stops seven days after your unemployment benefits end.
If you need health insurance and do not have much income, you may be able to get free or low-cost health insurance from MassHealth, Commonwealth Care, or the Health Safety Net. You must fill out a Medical Benefits Request (MBR) or Update Form to see if you are eligible.
MassHealth has set up a special process to make it easier for people who have lost their Medical Security Program coverage to apply for these programs. For information and forms, see Information for People Losing Medical Security Program Benefits.
If you do not qualify for free or low-cost government subsidized health insurance, you may be able to afford government-approved "good value" private health insurance through Commonwealth Choice. See Commonwealth Choice for details.
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Medical Security Program last updated on 7/21/10
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