West Virginia Health Insurance

According to the Center for Disease Control, an average of 14.8% of West Virginia residents went uninsured for West Virginia health insurance each year between 2001 and 2003.

West Virginia Health Insurance Regulations

West Virginia individuals who have health insurance through an employer or group plan cannot be denied or limited coverage because of health. Individual West Virginia health insurance plans, however, can deny any applicant on the basis of health, age, or other factors. West Virginia health insurance policies contain a guaranteed renewablility provision which states that any individual is guaranteed the right to renew an existing West Virginia health insurance policy provided there has been no fraud and all premiums have been paid on time.

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Pre-Existing Conditions

West Virginia health insurance companies can limit coverage for pre-existing conditions. Some policies can include elimination riders which permanently exclude a condition or body part from coverage for the duration of the West Virginia health insurance plan. Other policies may have pre-existing condition exclusion periods. These periods exclude any pre-existing condition from coverage for a limited time. A pre-existing condition in West Virginia is one that has been diagnosed or treated during the two years prior to the beginning of the West Virginia medical insurance plan. Continuous coverage under a health insurance plan prior to a new West Virginia health insurance policy can credit the new pre-existing exclusion period.

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Pregnancy

Pregnancy may be considered a pre-existing condition. Newborns and adopted children are automatically covered under a parent’s individual West Virginia health insurance policy for the first 31 days after birth or adoption if the parent’s insurance covers dependents.

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Rates

West Virginia health insurance rates vary and companies can charge an individual more based on health, age, and other factors. They are also free to deny coverage to any applicant. HMOs, however have a small period of open enrollment during which time any applicant can gain access to individual health insurance.

For individuals who may be between plans or employers, some West Virginia health insurance companies offer conversion policies and temporary West Virginia medical insurance.

Alternative West Virginia Health Insurance Options

Some individuals may have difficultly obtaining West Virginia medical insurance. There are some state programs that may be of assistance:

• West Virginia Small Business Plan helps make company-sponsored health insurance more affordable by combining large West Virginia health insurance companies and state government organizations. Small businesses must meet qualifying criteria.
• West Virginia Medicaid is available to any eligible individual who meets the qualifying criteria.
• West Virginia Children’s Health Insurance Program is designed to provide health insurance for children under 19 whose families do not qualify for Medicaid and who may not be able to afford West Virginia health insurance.
• AccessWV is West Virginia’s high risk pool that allows individuals who might be considered “uninsurable” to gain access to West Virginia medical insurance through the state program. Pre-existing condition periods may apply.

West Virginia Insurance Commission

Mailing Address:
Post Office Box 50540
Charleston, West Virginia 25305-0540

Telephone (304) 558-3707
General Consumer Service 304-558-3386
Toll Free 1-888-TRY-WVIC (1-888-879-9842)
Consumer Service(TDD) 304-558-1296
Toll Free(TDD) 1-800-435-7381

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For other West Virginia Insurance Resources, See:

• West Virginia Auto Insurance
• West Virginia Home Insurance
• West Virginia Health Insurance

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