Massachusetts Division of Insurance
The Massachusetts Division of Insurance is responsible for regulating all types of insurance sold in the state of Massachusetts - including health insurance policies.
If you are looking for health insurance coverage, the Division of Insurance can help you find an insurance agent or insurance company that is licensed to do business in Massachusetts. You can contact them at the phone number listed below, or conduct your own search online.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Division of Insurance. You can download a complaint form and mail it in, or contact the Division of Insurance by phone at the number listed below for more assistance.
Massachusetts Division of Insurance
1 South Station, 5th Floor
Boston, MA 02110
Phone: 617.521.7777
http://www.mass.gov/doi
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees - for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage - for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan - contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Boston Regional Office
J.F.K. Building, Room 575
Boston, MA 02203
James Benages - Director
Phone: 617.565.9600
Fax: 617.565.9666
http://www.dol.gov/ebsa/
Buying Individual Policies in Massachusetts
Massachusetts recently instituted a mandate requiring all residents to obtain health insurance coverage, either through their jobs or on their own in the private market. Fortunately,insurers in Massachusetts ARE NOT PERMITTED to reject any application for coverage on the basis of health status. However, they may impose a pre-existing condition exclusion period of up to twelve months upon those individuals who do not have prior continuous coverage.
"HIPAA-eligible" individuals are exempt from these pre-existing condition exclusion periods. You may be HIPAA-eligible if you:- had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
- you have exhausted all COBRA continuation coverage which was available to you.
If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Division of Insurance can help you find out.
Massachusetts Children's Medical Security Plan (CMSP)
CMSP provides health insurance coverage for children under age 19 at any income level who are not eligible for Medicaid benefits through MassHealth.
CMSP
Phone: 1.800.909.2677
http://www.mass.gov/?pageID=eohhs2terminal&L=4&L0=Home&L1=Consumer&L2=Insurance+(including+MassHealth)&L3=Additional+Insurance+and+Assistance+Programs&sid=Eeohhs2&b=terminalcontent&f=masshealth_consumer_additional_ier_cmsp&csid=Eeohhs2
Massachusetts Serving the Health Information Needs of Elders (SHINE)
SHINE provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the new Part D prescription drug benefit, or Medigap coverage.
Telephone contact information for your local Massachusetts SHINE office can be found here.
Massachusetts SHINE
Phone: 1.800.243.4636
http://www.mass.gov/?pageID=elderssubtopic&L=3&L0=Home&L1=Health+Care&L2=Serving+the+Health+Information+Needs+of+Elders+(SHINE)&sid=Eelders
MassHealth
MassHealth is the Medicaid program for Massachusetts. Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about MassHealth, including an application for enrollment, contact MassHealth at the number listed below.
Masshealth
Customer Service Center
55 Summer Street
Boston, MA 02110
Phone: 1.888.665.9993
http://www.mass.gov/?pageID=eohhs2agencylanding&L=4&L0=Home&L1=Government&L2=Departments+and+Divisions&L3=MassHealth&sid=Eeohhs2
