|
SolveYourProblem
Article Series:
Health Insurance
Your
State's Health Insurance Pool: Requirements
State
health insurance is a branch of health insurance that is
for high-risk individuals with chronic and/or
pre-existing conditions. Most common diseases to see on this
type of insurance are HIV, AIDS, kidney disease, obesity, and
diabetes. This high-risk pool is designed to act as a safety
net to offer some form of insurance to these people but for
a hefty premium. This program has fewer participants due to
the cost. This plan is not low-income friendly. Rates can be
as much as double what the normal market value for health insurance
is. The pool does tend to offer better benefits but is definitely
geared to those people that truly afford insurance. So, most
people who fall under this category and require this type of
plan are likely to be uninsured due to not being able to afford
a plan. This plan is last resort for persons with such illnesses
that land them for emergency or hospital care frequently, and
it that case pays for itself quickly. Some of the few persons
who cannot afford this are lucky enough to have a spouse in
the work place that is able to add them to their policy from
their employer, these plans cannot discriminate due to chronic
or long-term illnesses. The State Health Insurance Pool knows
its rates are high, and claims so are medical costs for the
chronically ill. They have to charge more to be able to get
ahead and stay afloat.
Most
risk pools are nonprofit associations ran by the state. Usually they do not use taxes to operate their business. Most
persons requiring this type of service usually are filling
up the gap in cost of what their normal plan won’t cover or
is a temporary pit stop till they can find a plan that accepts
them at a lower cost. The people who qualify for this type
of coverage must be a resident of the state they are applying
in. Most states require you live there for at least six months
and some up to one full year before reaching residency status.
You also need one of several possible documents from other
insurance companies. You will need proof of rejection from
at least one company denying them benefits similar to the ones
being asked for. You can use proof of insurance with a higher
premium as well. You may also be eligible if you can show proof
of insurance with a rider or rated policy. Any of the above
mentioned could get you approved to apply for the risk pool
in the state you reside in. A reciprocity agreement is when
a person who is eligible for the plan and is currently on a
similar plan, met the waiting period quota, and not used up
the lifetime maximum benefits can still be eligible if they
move to another state after they meet the residency requirement.
Not all states, but most, have this agreement included into
their plan.
There
is a list of those who are not eligible in the high-risk
pool besides non-residents. You are no longer eligible if you
move to another state but if you have a reciprocity agreement,
you can become eligible in the state you now reside after residency
has been established. Most people who are eligible or receive
Medicaid or Medicare are also not eligible. Many states do
have a high-risk plan for Medicare eligible persons, but if
you receive or could receive Medicaid than you don’t qualify.
If a person has terminated their coverage in another plan and
less than 132 months have passed they are not eligible for
the pool till that time is up. Those who have used their maximum
lifetime benefits for their plan are also not qualifying. Inmates
of a public institution are also not eligible for the risk
pool. Other specific exclusions can include state decided specific
diseases or medical conditions that they just don’t want to
cover. An enrollment cap may also be in affect so only a specific
amount of persons may be actively enrolled at any given point
of time. All other applicants who are eligible will be placed
on a waiting list till there is an opening. There seem to be
a higher list of those who don’t qualify then who do for this
high-risk benefit that costs an arm and a leg anyway. Click here to to view health insurance quotes, compare plans side-by-side and apply for the most affordable health insurance within your budget. I did this myself (June 17, 2011) to change my health insurance policy. Saved me $84 per month (or $1,008 per year). It's my SolveYourProblem recommendation.
# # # # #
by SolveYourProblem.com
: 2006
> Home > Health
Insurance: Main Page
|
