In New Hampshire, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, however the laws protect you in the following ways.
- Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more because of your health status. This is called nondiscrimination.
- All group health plans in New Hampshire must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
- Your health insurance cannot be canceled because you get sick. Most health coverage is guaranteed renewable.
- If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA or state continuation coverage. For example, it can help when you are between jobs, or when you retire early and are not yet eligible for Medicare. There are limits on what you can be charged for this coverage.
- If you lose your coverage under a fully insured group health plan and meet other qualifications, you are guaranteed the right to buy conversion coverage. You will not face a new pre-existing condition exclusion period.
- If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you can buy health insurance from the New Hampshire Health Plan. You will not face a new pre-existing condition exclusion period if you are HIPAA eligible. There are limits on what you can be charged for this health insurance.
- If you are not HIPAA eligible and have had difficulty obtaining affordable individual health insurance because of your health condition, you may also be eligible for health insurance from the New Hampshire Health Plan. If you are eligible because of health reasons and you have had no previous health coverage, you may face a new pre-existing condition exclusion period. There are limits on what you can be charged for this insurance.
- If you are a small employer buying a fully insured small group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All fully insured health plans for small employers must be sold on a guaranteed issue basis.
- If you are a small employer buying a fully insured group health plan, there are limits on what you can be charged due to the health status and some other factors of those in your group.
- If you are self-employed, you may qualify to buy a fully insured small group health plan as a business group of one.
- If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The New Hampshire Medicaid program offers free health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.
- If your children are 19 years old or younger and do not have health insurance and meet other qualifications, you may be able to buy health insurance for them through the New Hampshire Healthy Kids Program, which offers subsidized health insurance for certain uninsured children.
- If you believe you may be at risk for cancer but are uninsured or underinsured, you may be eligible for screening and treatment. The Let No Woman Be Overlooked Breast and Cervical Cancer program provides free cancer screening for qualified residents. Some women diagnosed with breast or cervical cancer through this program may be eligible for medical care through Medicaid.
- If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage. This coverage is called the Health Coverage Tax Credit, and is equal to 65% of the cost of qualified coverage, including COBRA, state continuation coverage and health insurance offered through the New Hampshire Health Plan.
- If you are a retiree aged 55-65 and receiving benefits from Pension Benefit Guaranty Corporation (PBGC), then you may be eligible for the HCTC.
