You May Need Help Understanding Massachusetts Health Insurance Laws

If you step back and look at the U.S. health care industry—all $3.8 trillion of it—with the multitude of specialties, innovative new treatments and the growing variety of health-related institutions, it becomes quite an understatement to say that medical care in our nation is complex. And it is costly. Health-related concerns cost about 18% of every dollar spent annually, which comes to an average of just under $11,600 per American.

Medical care in Massachusetts is no more nor less complex and costly than in any other state. However, the Bay State is one step ahead of the rest of the nation in its approach to paying for health care. Four years prior to the national Affordable Care Act (ACA), Massachusetts successfully enacted its own health insurance reforms.

Massachusetts Led the Way

As with the federal ACA, the Massachusetts health care statute focused on the need for corporations to offer health insurance plans to their workers. Unlike the national law, which requires a company to have 50 full-time workers before it must provide an insurance option, however, Massachusetts set the bar at 11 full-time or equivalent employees. Because the state law in some respects is more stringent than the ACA version, the federal government has allowed the state to retain its provisions. Much of the distinctions between the two are quite technical. To understand your possible coverage alternatives and costs, you can consult masshealthplans.com.

Insurance Is Important Regardless of Age

To understand how essential health care insurance is to individuals of any age, compare it to the seatbelt or the airbag in your car. Seatbelts and airbags were not always required equipment in passenger vehicles. Then it was discovered that these safety devices saved lives and prevented catastrophic injury. Just as no driver intends to have an accident, so no individual intends to need health insurance. As the recent pandemic demonstrated, however, illness and catastrophic medical expenses are no respecter of age. Neither are infectious diseases, undiagnosed genetic propensities or unexpected traumas. There is no age at which health insurance is not a necessity. In an article on the worst insurance mistakes made by consumers, Forbes pointed out the fallacy of believing young people do not need health insurance, saying, “not having adequate coverage at a young age could lead to wealth erosion at the time of an unforeseen medical emergency.”

Open Enrollment Is Not the Only Time to Acquire Health Insurance

Another excuse you may hear people use to avoid purchasing health insurance has to do with timing. Specifically, if it is before or after the ACA open enrollment period—which is November 1 through January 23 for Massachusetts—it is assumed you cannot buy health insurance. In actuality, the state government understands that life happens and your health insurance needs do change. Therefore, if the open enrollment period for a given year has passed, you can apply through the connector for a waiver to purchase health insurance.

Along with your health insurance policy comes the peace of mind of knowing you are not only safeguarding your health but also your financial well-being.

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