We offer access to more sources of health insurance quotes for individuals, families and groups in the state of Massachusetts than any other resource on the Internet. The information and resource links provided below are designed to help you learn more about finding affordable medical insurance in your state. Know your options. Understand your choices.

Massachusetts (MA)
Individual Health Insurance Regulations

Learn more about Massachusetts Individual Health Insurance

Individual health insurance policies in Massachusetts are not permitted to be medically underwritten. Accordingly, you may not be denied coverage based upon your current health status or past health history. Massachusetts requires health insurance carriers who sell individual health insurance policies to offer standardized policies to all applicants. Standardized plans are broken down into three categories: 1) Medical Plan Option 2) Preferred Provider Plan Option and 3) Managed Care Plan Option. All plan options must offer comprehensive coverage, including hospital and physician care, maternity care, preventive care and immunizations and prescription drug coverage. Exclusionary and look back periods on pre-existing conditions are limited to 6 months. Provided there is no more than a 63 day break in coverage, credit for prior coverage is required. Premium rates are determined under a modified community rating system and may vary based on age, family size and geographic location.

Massachusetts (MA)
Small Group Health Insurance Regulations

A small group, for the purpose of health insurance in Massachusetts, is defined as a group of employees between 1 and 50. Small group health insurance in Massachusetts is issued on a guaranteed issue basis, meaning that no group can be denied health insurance coverage as a result of their overall health history. Under an employer-sponsored group health plan, employers may require employees to incur a waiting period before becoming eligible to apply for coverage under the group health plan. Applicants not able to provide proof of prior creditable coverage may be subjected to a 6 month pre-existing condition exclusionary period by the health insurance carrier. Group health insurance rates in Massachusetts are community based and may vary in accordance with age, industry, group size, geography, family composition and group participation percentages. Discounted rates are available to groups that participate in wellness programs. Health insurance companies in Massachusetts must also offer group health insurance to self-employed groups of one.

Massachusetts COBRA and Continuation Coverage

Since all individuals in Massachusetts are eligible for personal medical insurance, COBRA and continuation options are of less importance. However, COBRA laws still exist to give people the option of remaining on their group health plan versus moving to an individual health plan. Groups of less than 20 must abide by the state mini-COBRA regulations, which closely follow the guidelines of federal COBRA that applies to larger companies. COBRA is a continuation of coverage under the employer sponsored health plan, which may be elected upon the occurrence of a specific qualifying event, allowing the employee to remain on the group health plan and receive the same level of coverage for a specific period of time. Under Massachusetts law, the period of time you may remain on the plan is dependent upon the qualifying event, with maximums of 18, 29 and 36 months. The premium for COBRA coverage may not exceed 102% of the cost of the employer sponsored health plan and shall be at the employee's sole expense. Conversion plans are also available for those that exhaust their COBRA options or elect this type of coverage over continuation on the group health plan.