Massachusetts Health Insurance

The commonwealth of Massachusetts imposes much more restrictive regulation on its insurance companies than other states, so it’s easy to assume that finding good health coverage here should be easy.  Shopping for health insurance is never something that should be approached carelessly, however, and unless you’re aware of exactly what insurers are and are not required to provide you can still end up with coverage that is less than ideal.  The list below covers a few of the key pieces of information that you’ll need when buying health insurance in Massachusetts.

  • As is common in most states, Massachusetts health insurance regulations require insurers to guarantee the renewability of every policy they sell.  In other words, so long as your application contains no false information and you’ve kept up with your premium payments, you will always have the option of renewing your coverage.  You are also protected from having your policy cancelled by your insurer if your health ever worsens.
  • Massachusetts prohibits health insurance companies from excluding coverage for any pre-existing condition, so there is no delay or exemption for coverage of any illness or injury that already exists when your insurance comes into effect.
  • There are a number of other standard benefits that insurers in Massachusetts are required to include in any health plan they sell, such as 31 days of automatic health coverage for new offspring of certain individual policy-holders.  If you’d like to know more, you can request an up-to-date listing of guaranteed benefits from the Massachusetts Department of Insurance.
  • Unlike most states, Massachusetts has made it illegal for insurers to deny health coverage to any new applicant on the basis of health or gender.  In addition, one’s state of health cannot be used as a justification for pricing of health insurance— only considerations like demographics, age, and location can be taken into account.
  • Small businesses in Massachusetts are guaranteed access to group health insurance with comparable benefits to health plans that are currently being offered to other small businesses in the commonwealth.  This goes for any enterprise having as few as two employees, or as many as fifty.
  • Health coverage for any small business in this state may be predicated on maintaining a certain minimum level of employee enrollment in the company’s health plan.  In addition, the employer may be required to contribute a certain amount toward each participating employee’s premiums.  Failure to meet the minimum requirements for the company’s group health plan can potentially result in the termination of coverage.
  • As with individual insurance, the pricing of a company’s group health plan cannot be affected by the insured employees’ health, and coverage cannot be cancelled on these grounds.  Characteristics like age, family status, demographics, and location can all contribute to the cost of group health coverage, however.
  • Self-employed workers in Massachusetts are permitted to buy group health coverage like any small business would, even if there are no other employees.  Premiums for individual health insurance, on the other hand, may be partially tax-deductible if you intend to itemize your deductions.

Although Massachusetts state law offers considerable protection for those who wish to buy health insurance, it’s still a good idea to know as much as possible about the companies, regulations, and options involved before you choose to purchase any new policy.  By carefully examining every offer you get, comparing rates, and knowing what to look for, you can vastly improve your chances of finding the kind of health coverage you want.

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