Successfully Navigating High-Risk Health Insurance Pools Most people in the United States feel that it is necessary for them to have secure and reliable health insurance as they go throughout their lives. Most people in the United States secure their health insurance through the company they work for, and their families are allowed to be on the same health insurance. However, there are a significant number of individuals who cannot get their health insurance this way, and so they must buy it independently of a specific company. Insurance companies who are providing insurance to individual people have the right to turn down a person applying for insurance if you have a serious medical condition. States are not required by law to offer back-up insurance for individuals who have been denied insurance in this way, but most states do. High risk health insurance pools are usually the path that people take when they cannot get individual coverage from an insurance company.
Who Qualifies for High Risk Health Insurance? Basically, high risk health insurance pools are private health insurance plans that are obtained through the state to individuals who are high-risk. The term “high-risk� encompasses many different conditions. For example, high-risk could mean you have cancer, AIDS, or any other serious disease or medical condition. There are several ways that you can apply for a high risk health insurance pool. One way you can apply is through an insurance agent. Another way you can apply is directly through the state. High risk insurance pools generally offer the same benefits and coverage options as regular health insurance plans. Common coverage options include coverage of prescription drugs, mental health, maternity, substance abuse, among others. Most high risk health insurance pools have very reliable and developed disease management programs, because so many individuals who get this health insurance have serious chronic illnesses. High risk health insurance is usually more expensive than traditional health insurance, for obvious reasons.
The way that risk pools determine how much you will pay for insurance depends on your age and which state you live in. Your specific medical condition and your prognosis will also play a part in how much you will pay for your insurance.
Availability of High Risk Health Insurance In order to prevent adverse selection from occurring, most high risk health insurance pools require preexisting condition waiting periods. Adverse selection is when people buy health insurance only after the onset of a disease or medical condition. Thirty-three states currently have high risk pools. Twelve of the remaining states have several other programs in place so that individuals who would need high risk insurance have a way to get insurance. Yet there are still five states that do not offer any insurance for high risk individuals. People who live in these states will probably have considerable trouble finding insurance. If you live in one of these states, you should probably meet with an insurance representative so that you can discuss your options for insurance. You may need to consider moving out of that state so that you can obtain reliable insurance. If you would like more information about high risk health insurance pools, you can go to the website for the National Association of Comprehensive Health Insurance Pools to find out more. Photo Credit: Alex, Alex Proimos, criana