Article Search:

Home | Finance


The Last Resort for the Medically Uninsurable

By: Adam J. Heist

Gone are the days when high-risk people were not eligible for any insurance programs. The state insurance pool is a program by which just about anyone can get the benefits of insurance plans. No wonder then that these plans are also called as guaranteed access programs.



People who have been termed as medically uninsurable by the medical program providers need not despair any more. The state insurance pool is a sturdy safety net for even people who fall into this category. The term medically uninsurable used to mean the people who were denied medical insurances because their health conditions was so bad that it would require lots of medical attention, and at times all that medical help would not help the person’s health to improve. However, the irony of this is, people with preexisting health conditions are in the direst need of health insurances, but these very same people were the ones who were denied the benefits of health insurances in the past. The COBRA benefit was there for such people (COBRA is the Consolidated Omnibus Budget Reconciliation Act of 1985); but these finances would generally get exhausted in long treatments, and the policyholders were not in a position to meet the steep demand of the insurance providers.



Rules of the state insurance pools differ from one state to another. There is a board of directors within each state, which work within the ambit of a nonprofit alliance within the state. The members of this board are taken from various insurance departments, such as the insurance industry, customers of individual insurance, members of state insurance departments, etc. The main responsibilities of these board of members is to work in collaboration with the mainstream insurance providers, and to check the applications they receive, select participants of their programs, collect their premiums, receive and pay out the claims and to answer all sorts of questions pertaining to the eligibility to the state insurance pool program.



The coverage provided is almost of the same quantum as in the 80-20 major medicals and outpatient coverage. Even then, some members could be denied the benefits of the plan because of potentialities of being uninsurable. However, the situation could change within a year. After that, the insurance can no longer be denied, so it becomes as much as a guarantee. So this plan is a boon for the people who were hitherto considered uninsurable. But it must be borne in mind that this policy is not a free policy. Actually, due to the risky health conditions of the participants they accept, the premiums on the state insurance pool policies could actually be higher than those on the mainstream policies. There is indeed a cap on the amount that the states can charge, but even so the prices are higher than those of competitive healthcare providers within each state. Generally speaking, this cap limit is about 125 to 150 per cent of the available rate in the market. The cap wouldn’t change, but the rate on the premiums could be a bit flexible, depending on factors such as the participant’s age, health condition and domicile address.



While applying it is necessary to attach the copies of the rejection from the other healthcare providers. Qualifications to get state insurance pool benefits include being a native of the particular state in which the application is being filed. If an insurance provider rejects an applicant, then that applicant would be considered HIPAA eligible if he/she provides evidence of recent eighteen months or more of uninterrupted healthcare coverage. The policy also extends to include minors within the family.



In the year 2003, thirty three of the fifty US states were already providing benefits of the state insurance pools to their citizens. Twelve states have made alternative arrangements. The District of Columbia has made a contract with the Carefirst Blue Cross / Blue Shield to make a plan which provides an open enrollment period. This plan also enables people with preexisting conditions to avail of healthcare benefits. There is a two-month waiting period for the plan to begin paying back. Pennsylvania and Rhode Island have also made contracts with Blue Cross / Blue Shield and use a plan that provides year-round enrollment to medically uninsurable people.



A very interesting factor is that such plans have been expanded to cover hurricane insurances also. For people living in hurricane-sensitive areas, there is the windstorm coverage pool, which provides the homeowners to buy extra coverage for their homes. Many people from coastal states such as Georgia and New York are providing such plans. They do this under their program named Fair Access to Insurance Requirement (FAIR).

Article Source: Free Content Articles Directory

Adam Heist is a freelance writer with many years of experience writing articles on Secured Loan related subjects. Take a few moments now to visit our site and see what we have in store for you.

Please Rate this Article

 

Not yet Rated

Click the XML Icon Above to Receive Finance Articles Via RSS!
Additional Articles From - Home | Finance
 Miscellaneous:
Writers:
Sign Up for a free account
Submit Articles
Member Login
Submission Guidelines
New Articles:
Ezine Notifications
Article RSS Feeds
Statistics:
Top Authors
Most Popular Articles
Today's Hot:
About Us
Link to Us
Contact Us
Privacy Policy
Terms of Service

Powered by Article Dashboard