Compare 2027 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 Includes Medical and Pharmacy
Annual Max Out-of-Pocket
Medical, Pharmacy and Pediatric Dental
 Office Visits Prescriptions
30-day supply		 ER Hospitalizations Per Admission
Platinum 0 Deductible 
Platinum 0 DeductibleSG

 Individual: $0
Family: $0*		 Individual: $3,500
Family: $7,000*		 PCP: $25
Specialist: $45		 Tier 1: $20
Tier 2: $40
Tier 3: $60		 $200 per visit $500
Gold 1000
Gold 1000SG		 Individual: $1,000
Family: $2,000*		 Individual: $7,500
Family: $15,000*		 PCP: $20
Specialist: $45		 Tier 1: $25
Tier 2: $45
Tier 3: $75 after deductible		 $250 per visit after deductible $500 after deductible
Gold 1800
Gold 1800SG

Individual: $1,800 
Family: $3,600* 

 Individual: $6,250
Family: $12,500*		 PCP: $30
Specialist: $60		 Tier 1: $30
Tier 2: $60 after deductible
Tier 3: $90 after deductible		 $300 per visit after deductible $750 after deductible
Silver 2000
Silver 2000SG		 Individual: $2,000
Family: $4,000*		 Individual: $12,000
Family: $24,000*		 PCP: $30
Specialist: $60		 Tier 1: $30
Tier 2: $60 after deductible
Tier 3: $90 after deductible		 $500 per visit after deductible $1,000 after deductible
Silver 2000 II Individual: $2,000
Family: $4,000*		 Individual: $12,000
Family: $24,000*		 PCP: $30
Specialist: $60		 Tier 1: $30
Tier 2: $60 after deductible
Tier 3: $90 after deductible		 $500 per visit after deductible $1,000 after deductible
Silver HSA 3000SG Individual: $3,000
Family: $6,000*		 Individual: $8,700
Family: $17,400*		 PCP: $30
after deductible
Specialist: $60 after deductible		 Tier 1: $30 after deductible
Tier 2: $60 after deductible
Tier 3: $105 after deductible		 $300 per visit after deductible $750 after deductible
Silver 4000
Silver 4000SG		 Individual: $4,000
Family: $8,000*		 Individual: $10,500
Family: $21,000*		 PCP: $30
Specialist: $60		 Tier 1: $30 
Tier 2: 35% after deductible
Tier 3: 35% after deductible		 35% after deductible 35% after deductible
Silver 7250 Individual: $7,250
Family: $14,500*		 Individual: $7,250
Family: $14,500*		 PCP: 0% after deductible
Specialist 0% after deductible		 Tier 1: 0% after deductible 
Tier 2: 0% after deductible
Tier 3: 0% after deductible		 0% after deductible 0% after deductible
Bronze HSA 5000
Bronze HSA 5000SG

 Individual: $5,000
Family: $10,000*		 Individual: $8,700*
Family: $17,400*		 PCP: $50 after deductible
Specialist: $80 after deductible		 Tier 1: $30 after deductible
Tier 2: $100 after deductible
Tier 3: $200 after deductible		 $750 per visit after deductible $1,000 after deductible
ConnectorCare Plan 2  Individual: $0
Family: $0

Medical
Individual: $750
Family: $1,500

Pharmacy
Individual: $500
Family: $1,000

 PCP: $5
Specialist: $20		 Tier 1: $10
Tier 2: $20
Tier 3: $40		 $50 per visit $50
ConnectorCare Plan 3  Individual: $0
Family: $0

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

Pharmacy
Individual: $750
Family: $1,500

 PCP: $10
Specialist: $25		 Tier 1: $15
Tier 2: $30
Tier 3: $50		 $100 per visit $250
Catastrophic Individual: $12,000
Family: $24,000*

Individual: $12,000
Family: $24,000*

PCP: $35 for first 3 visits, then 0% after deductible

Specialist: 0% after deductible

 Tier 1: 0% after deductible
Tier 2: 0% after deductible
Tier 3: 0% after deductible		 0% after deductible 0% after deductible

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.