Compare 2024 WellSense Clarity 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 0 Deductible
Gold 0 DeductibleSG
Individual: $0 (Medical)
Family: $0* (Medical)
Individual: $6,000
Family: $12,000*
PCP: $30
Specialist: $55
Tier 1: $30
Tier 2: $60
Tier 3: $90
$350  $750
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: $9,450
Family: $18,900*
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: $9,450
Family: $18,900*
PCP: $25
Specialist: $60
Tier 1: $30
Tier 2: $55
Tier 3: $75 after deductible
$350 after deductible $1,000 after deductible
Silver 3000
Silver 3000SG
Individual: $3,000
Family: $6,000*
Individual: $9,450
Family: $18,900*
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
Individual: $0
Family: $0

Pharmacy
Individual: $250
Family: $500

PCP: $0
Specialist: $0
Tier 1: $1
Tier 2: $3.65 
Tier 3: $3.65
$0 $0
ConnectorCare Plan 2  Individual: $0
Family: $0

Medical
Individual: $750
Family: $1,500

Pharmacy
Individual: $500
Family: $1,000

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
Individual: $1,500
Family: $3,000

Pharmacy
Individual: $750
Family: $1,500

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.