Massachusetts Health Insurance Enrollment & Coverage Information
When can I enroll?
Health plans for individuals and small groups became available July 1, 2007 and you can join at any time. Keep in mind that if you buy a plan and have had a break in your health coverage of more than 63 days, your plan may impose a pre-existing condition limitation of up to six months or a waiting period of up to four months.
Can my insurance application be denied because of my medical history?
No. Carriers CANNOT deny coverage due to your:
- age,
- occupation,
- actual or expected health condition,
- claims experience, the length of your coverage, or
- health.
Companies MAY deny coverage for several reasons including:
- you live outside their service area,
- you have not paid the plan premiums or
- you gave false information on your application or claim forms.
Companies MAY place these limits:
- pre-existing condition limit for up to the first six months of your coverage. This means that for up to six months they will not pay for services related to a health condition that you had before you joined the plan.
- waiting period for up to the first four months of your coverage. During the waiting period, the plan will only pay for emergency services.
- If you had another health plan for up to 63 days before you apply for the new plan, the company must waive or reduce the time of these two limits.
Resources:
- » Programs for Children and Adults with Disabilities and Special Health Care Needs
- » Medicaid Waivers to Help Children with Health Insurance Eligibility
- » Special Medicaid Waivers for Home-Based Health Care
- » Developing Your Own Medicaid Waiver
- » Medicaid Appeals and Eligibility Rules Regarding Obtaining Health Care Coverage
Articles:
- » Changes in Medicaid Rules that Affect Children and Medicaid HMO's
- » Health Care Services Covered by Medicare HMO's
- » Medicare and Other Laws and Programs Providing Health Insurance Coverage
Massachusetts Health Guide Pages:
- » Massachusetts Health Insurance Consumer Guide to Individual and Small Group Coverage
- » Massachusetts Individual Health Insurance Eligibility & Availability
- » Massachusetts Health Insurance Options for Small Businesses
- » Massachusetts Health Insurance Enrollment & Coverage Information
- » Massachusetts Health Insurance Limitations, Waiting Periods & Coverage
- » Massachusetts Health Insurance Costs & Nongroup Coverage
- » Massachusetts Health Insurance Payment Assistance Programs
Links:

