What You'll Lose in Massachusetts

Massachusetts Comparable Federal Rule for AHPs?

Coverage of important benefits

  • Insurers must cover: mental health parity that goes beyond federal requirements, alcoholism treatment, maternity benefits, mammography screening, invitro fertilization, and well-child care.

 

NoNE


Appropriate access to care

  • Insurers must cover: emergency services that a "prudent layperson" thought necessary, transitional care from a provider who leaves a network, direct access to OB/GYNs, and cancer clinical trials.

  • Law prevents insurers from "gagging" doctor-patient communications.

 

NoNE

Promotion of access to healthcare for the uninsured

  • Small business employees have continued access to healthcare when they leave their job.

 

NoNE

Fair healthcare premiums

  • Insurers canNot set premiums based on your health status.

  • Insurers canNot increase premiums when you get sick.

 

NoNE

Ensured payment of claims

  • Insurers must have financial reserves to cover claims.

  • State will take corrective action and seize assets to pay claims.

 

NoNE

Truth in marketing

  • Marketing materials must follow detailed guidelines.

 

NoNE

Prompt payment rules

  • Insurers must pay providers within reasonable required timeframe.

 

NoNE

Proper oversight of insurers

  • Management of complaints from you and your healthcare provider.

  • Investigation, oversight, and enforcement of plan rules (including financial penalties).

 

NoNE