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- 15,200Fallon members affected by its smaller service area
- 4,800Tufts Direct members in Berkshire County
- Dec 23pick by this date for coverage on January 1
One honest note. I am licensed in Massachusetts, but I am not a certified broker with Massachusetts Health Connector, the state's own exchange. If you qualify for financial help or want a plan sold there, Massachusetts Health Connector and its certified helpers can enroll you, and I will point you to one. Where I can help directly is comparing your options, including private plans sold outside the exchange.
What is happening in Massachusetts
Fallon Health is shrinking its service area to central Massachusetts, affecting about 15,200 enrollees, and Tufts Direct is leaving Berkshire County, affecting about 4,800. If either describes your plan, your renewal notice is a decision, not a formality.
About 30,000 to 35,000 lawfully present immigrants in Massachusetts are also expected to lose federal premium tax credits on January 1, 2027, and with them ConnectorCare. Prices are rising too. The Division of Insurance approved an average increase of 10.4 percent for the merged market, and about 12.4 percent for unsubsidized individual plans once you account for members getting a year older.
Where carriers are leaving
Carrier exits for 2027 are real, and they are spread across the country. Cigna is leaving the individual market in all 11 states where it sells. Baylor Scott & White is leaving Texas, CareSource is leaving Indiana, Ohio and West Virginia, Medica is leaving Iowa, Kansas and Oklahoma, and several smaller carriers are leaving other states. If you moved recently or have family elsewhere, the all states overview lists them.
What this means for you
If you get a subsidy, the headline increase is not what you pay. Your subsidy is recalculated on your estimated 2027 income, and it usually absorbs much of a price increase. Updating your income estimate matters more than the rate filing.
If you do not get a subsidy, you feel the full increase. This is where it pays to compare more than one kind of coverage. Private major medical plans are priced differently from ACA plans, and for some people who pay full price they can cost less for similar coverage. I compare both, side by side, so you can see the real numbers for your household.
The practical point: if your carrier stays, most plans renew automatically at the new 2027 price. If your carrier leaves, you may be moved automatically into a plan someone else picked. Neither checks whether a different plan now costs less or fits your doctors better. That check takes a few minutes.
The dates that matter in Massachusetts
Massachusetts runs its own exchange, Massachusetts Health Connector, so it sets its own calendar. These are the dates Massachusetts Health Connector has published for 2027 coverage.
- Fall 2026Renewal notices arrive with your 2027 price. Read it, even if you plan to keep your plan.
- October 23, 2026Open enrollment began on the Massachusetts Health Connector.
- December 23, 2026Enroll by this date for coverage starting January 1, 2027.
- January 23, 2027Open enrollment closes. Enrollments from December 24 on start February 1.
What to do, in order
Read your renewal or non renewal notice
It shows your 2027 premium and any plan changes. Compare it with what you pay today.
Write down your doctors and your prescriptions
The physicians you want to keep and the exact drugs with dosages. Networks and drug lists change from year to year even when the carrier stays.
Update your income estimate for 2027
Your subsidy is based on your estimated income for the year ahead. If it changed, your real cost changes with it.
Compare before December 23
That is the last day to pick a plan that starts January 1 in Massachusetts. Compare on total cost, meaning premium plus deductible plus what you expect to use, and include private options if you pay full price.
Common questions
Is my health insurance company leaving Massachusetts in 2027?
Not entirely. Fallon Health is shrinking to central Massachusetts, affecting about 15,200 enrollees, and Tufts Direct is leaving Berkshire County, affecting about 4,800.
Why is my premium changing for 2027?
The Massachusetts Division of Insurance approved an average increase of 10.4 percent for the merged market for 2027, and about 12.4 percent for unsubsidized individual plans once age is included. If you get a subsidy, your net cost depends on your 2027 income.
Do I have to use a broker?
No. You can enroll yourself at Massachusetts Health Connector at no cost. A licensed broker also costs you nothing, because brokers are paid by the carriers and the premium is identical either way. A broker can also show you private plans that are not sold on the marketplace.