About Health Insurance in Massachusetts
Since Massachusetts has a Guarantee Issue Health Insurance plan, we only provide insurance through one company, Fallon Community Health Plan. You have a variety of other options, and because guarantee issue details can get confusing, we have provided information to help.
- Total Population: 6,613,100
- Total Uninsured Population: 327,900 (16%)
- Typical Cost of Inpatient Hospital Visit Per Day: $2,419
- Average State Premium for Individual Health Insurance: $437
Information provided by Kaiser Family Foundation, 2010.
Choosing a Plan in Massachusetts
East Coast Health Insurance simplifies the process of getting a quote for residents of Massachusetts. Start by entering your zip code above, or for extra assistance you can speak with one of our experts in the state to find your best options over the phone at 888-803-5917.
Other Options in Massachusetts
- For questions on Guarantee Issue Health Insurance, call the Massachusetts Division of Insurance 617-521-7777
- Blue Cross Blue Shield of Massachusetts: www.bluecrossma.com
- SCHIP Children’s Medical Security Plan: 617-624-6000
Massachusetts Health Insurance Market & Laws
Massachusetts health insurance regulations greatly advocate consumer rights. Most of the laws in place are set up to protect the insurance policy-holder and ensure they receive necessary benefits.
Unlike other states, Massachusetts health insurance companies are not permitted to give exclusion periods for pre-existing conditions. Therefore, the insurer is always required to provide coverage for medical care you receive for any condition with which you have been diagnosed before your health plan began.
The guaranteed renewability provision is an important law in Massachusetts, because it allows you the right to renew your health insurance policy at the end of a term with the same company. This provision is required by federal law to be included in all health insurance. Because of this law, your insurer must allow you to renew your existing policy if you have met your premiums and have not violated your policy.
Also, if a health insurance plan covers dependents, it is required by law that newborns and adopted children be covered under their parents’ individual health insurance for the first 31 days after birth or adoption.
Health insurance companies are regulated on the basis of consumer rights in Massachusetts. The laws in place are designed to give fair and equal treatment to those who apply for health insurance.
A very important law is that Massachusetts health insurers are not allowed to decline your application for health care based on age, risk of future illness, or health standings. They also cannot increase your costs due to your health or gender, like companies in many other states are allowed to do. Factors that do affect rates are your age, income, and the size of your family.
In Massachusetts, the following services are mandatory for all health plans to cover:
- Maternity care
- Home health care and hospital care
- Supplies and treatment for diabetes
- Breast, prostate, cervical, and colorectal cancer screenings
- Speech, language, and hearing disorder care
For further information on Massachusetts health insurance laws, visit the Division of Insurance site.
1. Kaiser Family Foundation, “Massachusetts – State Health Facts”. www.statehealthfacts.org
2. Health Insurance In-Depth, “Massachusetts Health Insurance”. http://www.healthinsuranceindepth.com/health-insurance-Massachusetts.html