Standard High Gold: WellSense Clarity Gold 1000
WellSense Health Plan MA · 2027 plan year
Gold
- Ind. deductible
- $1,000
- Family deductible
- $2,000
- Ind. OOP max
- $7,500
- Family OOP max
- $15,000
Compare with other Gold plans in MA
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More WellSense Health Plan MA plans in MA
Monthly premiums by age
Rating Area 1 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.
| Age | Individual |
|---|---|
| Under 15 | $375 |
| 21 | $591 |
| 30 | $643 |
| 40 | $695 |
| 50 | $869 |
| 60 | $1,181 |
| 64 and over | $1,181 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $45.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $250.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | $500.00 Copay per Stay after deductible |
| Outpatient Surgery Physician/Surgical Services | No Charge after deductible |
| Urgent Care Centers or Facilities | $45.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $25.00 |
| Non-Preferred Brand Drugs | $75.00 Copay after deductible |
| Preferred Brand Drugs | $45.00 |
| Specialty Drugs | $75.00 Copay after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $500.00 Copay per Stay after deductible |
| Mental/Behavioral Health Outpatient Services | $20.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | No charge |
| Acupuncture | $20.00 |
| Allergy Testing | $45.00 |
| Bariatric Surgery | $250.00 Copay after deductible |
| Basic Dental Care - Child | 25.00% Coinsurance after deductible |
| Chemotherapy | No Charge after deductible |
| Chiropractic Care | $45.00 |
| Delivery and All Inpatient Services for Maternity Care | $500.00 Copay after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Education | No charge |
| Dialysis | No Charge after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | No Charge after deductible |
| Eye Glasses for Children | 20.00% Coinsurance after deductible |
| Habilitation Services | $45.00 |
| Hearing Aids | 20.00% Coinsurance after deductible |
| Home Health Care Services | No Charge after deductible |
| Hospice Services | No Charge after deductible |
| Imaging (CT/PET Scans, MRIs) | $200.00 Copay after deductible |
| Infertility Treatment | $45.00 |
| Infusion Therapy | No Charge after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | $25.00 Copay after deductible |
| Major Dental Care - Child | 50.00% Coinsurance after deductible |
| Nutritional Counseling | $45.00 |
| Orthodontia - Child | 50.00% |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $250.00 Copay after deductible |
| Outpatient Rehabilitation Services | $45.00 |
| Prenatal and Postnatal Care | No charge |
| Prosthetic Devices | 20.00% Coinsurance after deductible |
| Radiation | No Charge after deductible |
| Reconstructive Surgery | $500.00 Copay after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $45.00 |
| Rehabilitative Speech Therapy | $45.00 |
| Routine Eye Exam (Adult) | $45.00 |
| Routine Eye Exam for Children | $45.00 |
| Routine Foot Care | $45.00 |
| Skilled Nursing Facility | $500.00 Copay per Stay after deductible |
| Substance Abuse Disorder Inpatient Services | $500.00 Copay per Stay after deductible |
| Substance Abuse Disorder Outpatient Services | $20.00 |
| Transplant | $500.00 Copay after deductible |
| Treatment for Temporomandibular Joint Disorders | $45.00 |
| Weight Loss Programs | 75.00% |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $35.00 Copay after deductible |
Service area
This plan covers 17 geographic areas. 7 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.