The Health Insurance Consumer Guides for Tennessee and West Virginia have been recently updated and posted to our website, where you can get them for no charge.
Click on the link below to go to the appropriate guide:
Karen Pollitz, project director for Georgetown University’s Health Policy Institute, spoke on a Kaiser Family Foundation panel about current health insurance coverage for families, pregnant women and newborns, and about current proposals that may change the way maternity charges are covered.
Speaking about consumer-driven health plans, or “CDHPs,” Pollitz was quoted as saying:
“[The medical cost of pregnancy and delivery] is an issue that consumers struggle with from time to time with health insurance regardless of what kind of plan you have … But the stakes are higher with these CDHPs because if you’re wrong or you have a claim you’re on the hook for so much more money.”
Pollitz offers guidance for those looking at family coverage options from health insurers, covered in an article from Dow Jones’s MarketWatch. Read it here: 10 things to consider about your insurer’s maternity coverage.
Read the full report, available at the Kaiser Family Foundation website: “Maternity Care and Consumer Driven Health Plans.”
Read the Washington Post’s coverage of the report: High-Deductible Plans Cost More for Maternity Care
healthinsuranceinfo.net has just revised its list of State High Risk Insurance Pools with the latest contact information for each, available on our website at: www.healthinsuranceinfo.net/managing-medical-bills/high_risk_pools_chart.htm
Thirty-two states operate high-risk pool programs for people who have trouble buying individual health insurance because of their health. Eligibility for these programs varies, as do premiums and covered benefits. Contact the program in your state for more information.
We strive to keep this information as current and useful as possible. If you know of any changes or updates, please leave us a comment below!
Georgetown University Health Policy Institute Project Director Karen Pollitz appeared as a guest on “Talk of the Nation” on May 11, 2007, on National Public Radio. The show covered recent developments in the health care reform movement in the United States. With 45 million Americans uninsured, this hot topic continues to receive close scrutiny from the authors and experts who provide information on your rights as a health care and insurance consumer, at healthinsuranceinfo.net.
You can read more and listen to the radio show on the NPR website: www.npr.org/templates/story/story.php?storyId=10136885.
Georgetown University’s Health Policy Institute has released updated Consumer Guides for South Carolina and Nevada.
Health insurance consumers, legislators, social workers and advocates use these guides for clear, comprehensive information on the rights that consumers have, and lack, as they enter the health insurance market in their state.
These guides are available in their entirety, for free, on this website in PDF format; see our copyright notice for reprinting and redistribution guidance.
Periodically, our experts at healthinsuranceinfo.net receive questions from consumers who are looking for guidance in the health insurance market. This question came to us recently.
Question: I am 59 years old and my wife is 54, our Cobra policy will be ending in September. Where do we go from here after our Cobra expires? Thanks for your assistance.
Answer: If you have exhausted COBRA and met other requirements, you will be ‘HIPAA eligible’ for coverage as an individual. HIPAA eligible means that all of the following are true:
Being federally eligible means that you have guaranteed access to individual health insurance coverage and will not be subject to any pre-existing condition exclusion periods.
Each state uses different methods to guarantee your access to coverage. Some states require individual health insurers to cover you while others may guarantee you high-risk pool coverage. Your state may use different options from these.
For more information about buying health insurance in your state, see our Consumer Guides to Getting and Keeping Health Insurance, available at healthinsuranceinfo.net.
Kevin Lucia M.H.P., J.D., Assistant Research Professor at Georgetown University, has co-authored an article in the Winter 2006 issue of the Journal of Insurance Regulation (www.naic.org/store_jir.htm).
Imposition of Durational Residency Requirements by State High-Risk Pools: Constitutional Considerations
Kevin Lucia, M.H.P., J.D.; Susanne Addy, J.D.
Currently, 32 states maintain high-risk pools offering individual health insurance to residents that are otherwise medically uninsurable in the private health insurance market. In many of these states, applicants are required to have resided in the state for a specific period of time, called a “durational residency requirement,” before they can apply for coverage. After reviewing how many states impose a durational residency requirement on new applicants and why, this article discusses the constitutionality of these requirements in light of the 14th Amendment right to travel as interpreted by relevant U.S. Supreme Court rulings.
Periodically, our experts at healthinsuranceinfo.net receive questions from consumers who are looking for guidance in the health insurance market. This question came to us recently.
Question: I am a 27 year old with cancer. Can I buy individual health insurance?
Answer: It depends. Insurers in the market are likely to turn you down, unless the law requires them to sell you coverage. However, depending on where you live and other circumstances, laws may require insurers to offer you an individual policy. If that is the case, it will also be important to know whether other laws limit what you can be charged for health insurance and whether your existing medical conditions will be excluded from coverage.
In a few states individual market insurers are required to guarantee issue all products to all residents year round. In these states, an application with cancer must be issued an individual policy just like everyone else.
In a handful of other states, Blue Cross/Blue Shield or other insurers must offer guaranteed issue coverage to all residents.
In addition, you will also want to get information about COBRA, state continuation coverage, state high-risk pools, association health plans, public programs (such as Medicaid), and other possible sources of health coverage.
For more information about accessing individual health insurance coverage, see our Consumer Guides to Getting and Keeping Health Insurance, available at healthinsuranceinfo.net.
Georgetown University’s Health Policy Institute has released updated Consumer Guides for Florida and Iowa, as of January 2007.
Health insurance consumers, legislators, social workers and advocates use these guides for clear, comprehensive information on the rights that consumers have, and lack, as they enter the health insurance market in their state.
These guides are available in their entirety, for free, on this website in PDF format; see our copyright notice for reprinting and redistribution guidance.
The December/January 2006 issue of Health Affairs, a Health Policy Journal, includes an article by our researchers:
Association Health Plans: What’s All The Fuss About?
The presumption that association health coverage has more market clout is not necessarily borne out by the evidence.
by Mila Kofman, Kevin Lucia, Eliza Bangit, and Karen Pollitz
ABSTRACT: Policy makers have tried to address the problem of the uninsured and to help small businesses with rising premiums by encouraging associations to offer coverage. Although supporters and opponents have made claims about the potential impact of this strategy, the association market has not been studied in depth. Examining current standards might explain why proponents seek changes. This paper discusses states’ approaches to regulating health insurance offered by associations, including “self-insurance,� as well as existing state exemptions from state insurance laws that otherwise would apply to coverage sold to small businesses, self-employed people, and individual purchasers. We also examine market problems such as insolvency and fraud.
