- Individual or Family Health
- Group Health Coverage
High Risk Pools May be Only Health Insurance Option for Some
There are over 30 States in the Union that offer so-called High Risk Pools for Medical Insurance. High Risk Pools unfortunately do not represent low cost health insurance, and in fact in most cases are more expensive then other types of health insurance coverage. However in the States that offer them, High Risk Pools may be the only option for individual diagnosed and being treated for certain diseases.
It is estimated that some 175,000 people nationwide have their health insurance through high risk pools. These risk pools offer healthcare insurance coverage much like to that of private health insurance policies, albeit usually at a higher price. High Risk Pool Insurance differs from State to State. There are states where Risk Pool Healthcare Insurance has stricter limitations than traditional medical benefits. For example, some High Risk Pool Health Insurance often carry deductibles that can be very high Or in some cases will have limited coverage for mental or emotional healthcare or for maternity care. Often Risk Pools will forgo exclusions for any pre-existing conditions so long as you can show proof of having had previous medical insurance coverage. Prior coverage is sometimes a requirement to qualify for High Risk Pool Insurance. There are also other parameters to qualify for High Risk Pool Insurance.
If it is available in your State you may qualify for High Risk Pool Insurance if:
- Have Received Notice of Rejection By an Insurer
- Have Received Notice of a reduction of benefits or a specific exclusion
- Have a Qualifying Chronic Condition Such as AIDS, Cancer, or Diabetes
- If your health insurance policy has been involuntarily canceled for any reason other than non-payment
- Have had an employer based policy in effect and are HIPPA Qualified
- Have exhausted COBRA Benefits
Once again understand that High Risk Pool Health Insurance is not low cost medical coverage. But for many meeting the criteria above it may be the only choice. High Risk Pool Insurance is always more expensive than private healthcare insurance. In most high-risk pools, the state sets premiums at least one-and-a-half to twice as high as health insurance premiums charged for private health insurance.
Furthermore, in all states risk pools monthly premiums are adjusted for age. Therefore risk pool medical insurance can be very costly for individuals over 50 but who may not yet qualify for Medicare. In some states due to the limitations of funds available for the high-risk pool, they must impose a limit on the number of enrollees. In these States you may encounter a waiting list or a lottery system when applying for High Risk Pool Heath Insurance.
To find out if High Risk Pool Insurance is offered in where you live, contact your States Commissioner of Insurance Office, or your State Department of Insurance.