State Updates

Massachusetts Releases Minimum Creditable Coverage Guidelines for 2025

July 30, 2024

The Massachusetts Health Connector has released its minimum creditable coverage (MCC) guidelines for 2025. These guidelines outline the essential health benefits that insurance plans must provide to comply with state regulations. They ensure that residents have access to comprehensive and affordable health coverage, including preventive services, prescription drugs, and emergency care. Adhering to these standards is crucial for individuals and employers to avoid tax penalties and ensure adequate protection under their health insurance policies.

The applicable deductible limits for calendar year 2025 will remain unchanged from 2024 and will be:

  • Individual Coverage Deductible $2,950.
  • Individual Coverage Separate Prescription Deductible $360.
  • Family Coverage Deductible $5,900.
  • Family Coverage Separate Prescription Deductible $720.

The applicable out-of-pocket limits for calendar year 2025 will be reduced from the 2024 limits and will be:

  • Self-Only Coverage Maximum Out of Pocket $9,200.
  • Family Coverage Maximum Out of Pocket $18,400.

Massachusetts residents are required to have health coverage that meets MCC guidelines or pay a penalty. Employers providing group health insurance to Massachusetts employees should be aware of these minimum creditable coverage guidelines for 2025.

Administrative Information Bulletin »

PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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