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High Risk Health Insurance
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High-risk individuals who are looking for health insurance can become eligible for high-risk medical insurance through their state. Currently there are thirty states with high-risk health insurance pools. These states are able to provide lower premium medical insurance for high-risk individuals through some forms of hospital taxes, state taxes, and the ability to negotiate lower premiums for high-risk medical insurance by “pooling” people into a group similar to employers.
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The following is a list of high-risk health insurance plans by state (note: you must be a resident of the state in which you are applying for high-risk medical insurance):
- Alabama Health Insurance Plan
- Alaska Comprehensive Health Insurance Association
- Arkansas Comprehensive Health Insurance Plan
- California Major Risk Medical Insurance Program
- Connecticut Health Reinsurance Association
- CoverColorado
- Idaho Individual High Risk Reinsurance Pool
- Illinois Comprehensive Health Insurance Plan
- Indiana Comprehensive Health Association
- Health Insurance Plan of Iowa
- Kansas Health Insurance Association
- Kentucky Access
- Louisiana Health Plan
- Maryland Health Insurance Plan
- Minnesota Comprehensive Health Association
- Mississippi Comprehensive Health Insurance Risk Pool
- Missouri
- Montana
- Nebraska
- New Hampshire
- New Mexico
- North Dakota
- Oregon Medical Insurance Pool
- South Dakota Risk Pool
- Tennessee's Tenncare Program
- Texas Health Insurance Risk Pool
- Utah Comprehensive Health Insurance Pool
- Washington State Health Insurance Pool
- Wisconsin Health Insurance Risk Sharing Plan
- West Virginia Health Insurance Plan
- Wyoming Health Insurance Pool
Eligibility
In the year 2003 the total number of people enrolled in high-risk health insurance plans through states topped 181, 441. The total claims for high-risk health insurance for the same period for those plans was over one billion dollars. The premium costs for high-risk medical insurance through state programs was also high for 2003 at $793,545,922.
According to the American Diabetes Association, there is more than one way to become eligible for your state's high-risk pool. These may include:
- If you receive a notice of rejection from a health insurer
- If you receive a notice of benefit reduction or specific condition exclusion
- If you receive a notice of premium rate increase or surcharge exceeding the pool rate
- If you have a qualifying condition (i.e. AIDS, cancer, diabetes)
- If you are eligible for Trade Adjustment Assistance because you lost employment due to increased imports, you may be eligible for a tax credit. In some states, this tax credit can be used for the HRP
- If you have been involuntarily terminated from a health insurance plan or
- If you are HIPAA-eligible. Note: You are HIPAA-eligible if you have had at least 18 months of prior continuous health coverage, at least the last day of which was in a group health plan; you have exhausted COBRA; you are not eligible for Medicare, Medicaid or a group health plan; you don't have other coverage; and you apply for new coverage (such as the high-risk pool) within 63 days of losing your prior coverage. If your state has designated the high-risk pool for HIPAA coverage, then it will not impose a pre-existing condition exclusion period on you when you are HIPAA-eligible.
Additional Information About High Risk Health Insurance
More information about high-risk health insurance can be found at:www.healthinsurance.org
Information about the National Association of Insurance Commissioners:www.naic.org
Information on HIPAA:www.hhs.gov
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