When it comes to choosing the right health insurance plan, your state of residence plays a significant role. Massachusetts and New Hampshire, although geographically close, offer very different healthcare systems, insurance mandates, and marketplace options. In this in-depth comparison, we’ll explore how Massachusetts health insurance compares with New Hampshire insurance options—covering everything from coverage benefits, premiums, and regulations to provider networks and subsidies.
Whether you’re a resident considering a move or simply weighing your options, this guide will help you understand the key differences and similarities in the health insurance landscapes of these two New England states.
1. Overview of Health Insurance in Massachusetts
Massachusetts has long been a pioneer in healthcare reform. In fact, the Massachusetts health reform law passed in 2006 served as a model for the federal Affordable Care Act (ACA).
Key Features:
- Individual Mandate: Massachusetts continues to enforce a state-level individual mandate, requiring all residents to have health insurance or face tax penalties.
- MassHealth: The state’s Medicaid and CHIP program, offering coverage to low-income individuals and families.
- Health Connector: The official state-based exchange (marketplace) where individuals, families, and small businesses can compare and enroll in health insurance plans.
Insurance Providers in MA (2025):
- Blue Cross Blue Shield of Massachusetts
- Tufts Health Plan
- Harvard Pilgrim Health Care
- Fallon Health
- All Ways Health Partners
- Health New England
Average Premium (2025 Estimates):
According to the Kaiser Family Foundation, the average benchmark premium for a 40-year-old in MA is $475/month before subsidies.
2. Overview of Health Insurance in New Hampshire
New Hampshire operates differently from Massachusetts in several key ways. The state relies on the federally facilitated marketplace (HealthCare.gov) and does not have a state-based exchange of its own.
Key Features:
- No State Individual Mandate: Unlike Massachusetts, New Hampshire does not require residents to have health insurance.
- Expanded Medicaid: New Hampshire adopted Medicaid expansion under the ACA and operates it through a program called the Granite Advantage Health Care Program.
- Uses HealthCare.gov: Residents use the federal exchange to compare and enroll in plans.
Insurance Providers in NH (2025):
- Anthem Blue Cross and Blue Shield
- Harvard Pilgrim Health Care
- Ambetter from NH Healthy Families
- Maine Community Health Options
Average Premium (2025 Estimates):
The average benchmark premium in NH for a 40-year-old is approximately $420/month before subsidies.
3. Key Differences Between Massachusetts and New Hampshire Health Insurance
| Feature | Massachusetts | New Hampshire |
| Marketplace Type | State-based (MA Health Connector) | Federally facilitated (HealthCare.gov) |
| Individual Mandate | Yes (state-level penalties apply) | No mandate |
| Medicaid Expansion | Yes (MassHealth) | Yes (Granite Advantage Program) |
| Average Premium (40-year-old) | ~$475/month | ~$420/month |
| Top Providers | BCBS MA, Tufts, Harvard Pilgrim, Fallon | Anthem NH, Ambetter, Harvard Pilgrim |
| Subsidies Available | Yes (state and federal subsidies) | Yes (federal subsidies) |
| Uninsured Rate (2024) | ~2.5% (lowest in the U.S.) | ~7.2% |
4. Medicaid and Low-Income Coverage Options
Massachusetts: MassHealth
- Covers children, pregnant women, disabled individuals, low-income adults
- Offers robust dental, mental health, and substance abuse services
- Income limits: Up to 138% of the FPL for adults, higher for children and pregnant women
New Hampshire: Granite Advantage Health Program
- Managed by private insurers through Medicaid Managed Care Organizations (MCOs)
- Income eligibility is also set at 138% FPL
- Includes access to physical, behavioral, and pharmacy services
5. Cost-Sharing Reductions and Subsidies
Both states offer premium tax credits and cost-sharing reductions to eligible enrollees.
Massachusetts Advantage:
Massachusetts offers Connector Care plans—subsidized plans with lower premiums, co-pays, and no deductibles for those under 300% of the FPL. These are only available through the state exchange and give the state a major edge for affordability.
New Hampshire:
Enrollees must qualify through HealthCare.gov standards, and although similar subsidies are available, New Hampshire does not provide additional state-funded reductions like Massachusetts.
6. Provider Networks and Access
Massachusetts:
- Home to several world-class hospitals including Mass General, Brigham and Women’s, and Beth Israel Deaconess
- Strong emphasis on value-based care
- More densely populated provider network
New Hampshire:
- Fewer urban centers mean fewer high-end hospitals
- Still maintains a strong network of general hospitals and clinics
- Access to Boston hospitals often covered in PPO/EPO plans
7. Which State is Better for Health Insurance?
Here’s a quick breakdown depending on your situation:
- Affordability for Low-Income Residents: Massachusetts wins due to Connector Care.
- Simplicity and Fewer Penalties: New Hampshire is better for those who don’t want an individual mandate.
- Better Access to Top-Tier Hospitals: Massachusetts
- Lower Premiums (on average): Slight edge to New Hampshire
Choosing between Massachusetts health insurance and New Hampshire insurance options depends on your income level, healthcare needs, and flexibility regarding provider networks. Massachusetts is ideal for residents who want strong coverage and are willing to comply with mandates, while New Hampshire offers more flexibility and slightly lower average costs.
Always use the respective official marketplaces—MA Health Connector or HealthCare.gov—to compare your plan options, calculate subsidies, and review provider networks.