Tuesday, January 15, 2013

2013 Massachusetts Insurance Mandates


Massachusetts appears to be ahead of the pack when it comes to health care reform compared to some other states across the U.S.  Massachusetts has already implemented health insurance exchanges and cooperatives which allow individuals to shop for more affordable health care.  Roughly around 98% of the population in Massachusetts is covered under a health insurance plan.  This percentage is among the nations highest which allows our state to be a model for all the other states.  Recently, Massachusetts has also passed into law these new health insurance mandates which will take effect in January 2013.

Coverage for Hearing Aids
Children who are affected by hearing loss or hearing impairments will be relieved to know health insurance carriers must provide coverage for their hearing aids.  Insurance carriers must provide up to $2,000 in coverage to go towards a single hearing aid or any services associated with obtaining a hearing aid.  If a family meets the $2,000 maximum, they will have to wait 3 years for this amount to reset.  This new benefit will be available for any individual who is younger than 21 years of age.

Cleft Lip/Palate Treatment
Health insurance carriers are required to cover certain services for children who are affected by a cleft lip or cleft palate.  Some services that will now be covered are restorative dental and medical surgeries as well as speech therapy.  Coverage will be provided for any child who is under the age of 18.  Please check with your health or dental insurance carrier to see what services or procedures would be covered.

Physician Assistant’s
When health insurance members have to go see their primary care provider for any services or procedures, they will now have the opportunity to have these procedures covered by the doctor’s physician assistant.  Health insurance carriers are now required to consider physician assistants equal to a primary care provider.

Coverage for Birth Control
For employer sponsored health insurance plans that renew on or after August 1, 2012 some birth control methods will be covered at 100% with no copayment to the member.  This new regulation is part of the Affordable Care Act and Health Care Reform.  To see if your birth control method is covered at no cost to you, please call your health insurance carrier member service team on the back of your ID card.

If you have any questions regarding these new state mandates, please contact our office at (978)-777-6554.

Thank You.