Compare 2025 WellSense Clarity MA plans
To see which WellSense Clarity plan you may qualify for, you need to first check your eligibility with the Massachusetts Health Connector. You can then choose your plan name below for more information.
Plan Name | Annual deductible |
Annual Max Out-of-Pocket
Medical, Pharmacy and Pediatric Dental |
Office Visits | Prescriptions 30-day supply |
ER Waived if admitted |
Hospitalizations Per Admission |
---|---|---|---|---|---|---|
Platinum 0 Deductible Platinum 0 DeductibleSG |
Individual: $0 Family: $0* |
Individual: $3,000 Family: $6,000* |
PCP: $20 Specialist: $40 |
Tier 1: $10 Tier 2: $25 Tier 3: $50 |
$150 | $500 |
Gold 1000 Gold 1000SG |
Individual: $1,000 Family: $2,000* |
Individual: $6,000 Family: $12,000* |
PCP: $20 Specialist: $40 |
Tier 1: $25 Tier 2: $45 Tier 3: $75 after deductible |
$250 | $200 after deductible |
Gold 1500 Gold 1500SG |
Individual: $1,500 (includes Medical and Pharmacy) Family: $3,000* (includes Medical and Pharmacy) |
Individual: $5,250 Family: $10,500* |
PCP: $30 Specialist: $55 |
Tier 1: $30 Tier 2: $60 after deductible Tier 3: $90 after deductible |
$250 after deductible | $750 after deductible |
Silver 2000 Silver 2000SG |
Individual: $2,000 Family: $4,000* |
Individual: $9,200 Family: $18,400* |
PCP: $25 Specialist: $60 |
Tier 1: $30 Tier 2: $55 Tier 3: $75 after deductible |
$350 per visit after deductible | $1,000 after deductible |
Silver 2000 II | Individual: $2,000 Family: $4,000* |
Individual: $9,200 Family: $18,400* |
PCP: $25 Specialist: $60 |
Tier 1: $30 Tier 2: $55 Tier 3: $75 after deductible |
$350 after deductible | $1,000 after deductible |
Silver HSA 2000SG | Individual: $2,000 Family: $4,000* |
Individual: $7,050 Family: $14,100* |
PCP: $30 after deductible Specialist: $60 after deductible |
Tier 1: $30 after deductible Tier 2: $60 after deductible Tier 3: $105 after deductible |
$350 after deductible | $750 after deductible |
Silver 3000 Silver 3000SG |
Individual: $3,000 Family: $6,000* |
Individual: $9,200 Family: $18,400* |
PCP: $30 Specialist: $60 |
Tier 1: $30 after deductible Tier 2: 35% after deductible Tier 3: 35% after deductible |
$750 after deductible | 35% after deductible |
Bronze HSA 3600 Bronze HSA 3600SG |
Individual: $3,600 Family: $7,200* |
Individual: $8,000* Family: $16,000* |
PCP: $60 after deductible Specialist: $90 after deductible |
Tier 1: $30 after deductible Tier 2: $120 after deductible Tier 3: $200 after deductible |
$875 after deductible | $1,500 after deductible |
ConnectorCare Plan 1 | Individual: $0 Family: $0 |
Medical Pharmacy |
PCP: $0 Specialist: $0 |
Tier 1: $0 Tier 2: $0 Tier 3: $0 |
$0 | $0 |
ConnectorCare Plan 2 | Individual: $0 Family: $0 |
Medical Pharmacy |
PCP: $0 Specialist: $18 |
Tier 1: $10 Tier 2: $20 Tier 3: $40 |
$50 per visit | $50 per visit |
ConnectorCare Plan 3 | Individual: $0 Family: $0 |
Medical Pharmacy |
PCP: $0 Specialist: $22 |
Tier 1: $12.50 Tier 2: $25 Tier 3: $50 |
$100 per visit | $250 per visit |
All preventive services are covered in full. Our plans meet the state mandate for health insurance coverage and offer a variety of cost-sharing options to employers.
*See plan document for more information.
Glossary
Coinsurance - Your share of certain covered services as a percentage of the service. For example if your plan's coinsurance is 10% for a covered service, and the service costs $100, you will pay $10. ($100 x 10%)
Copay- The set amount you pay for services such as prescription drugs or a doctor's office visit.
Deductible - The amount you have to pay for services before your plan starts to pay.
Annual Max Out-of-Pocket - The most you could pay during a coverage period (usually one year) for your share of covered services, which include copays, deductibles and coinsurance.
Premium - The amount you pay each month to get coverage.
Preventive Care - Care that helps you stay healthy, like flu shots and wellness visits or diabetes and cancer screenings.
Specialist - A doctor who has extra training in an area of medicine, such as cardiology, dermatology, or pediatrics.
*Please see the current year's Evidence of Coverage and Schedule of Benefits for specific information on each plan, or additional information including which benefits, services and medications are covered or non-covered on our plan- and any restrictions or guidelines we must follow before providing them. You can find doctors and hospitals in our network here, see our privacy practices, and learn how we make sure you get the right care at the right time with our Utilization Management policy.
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