Introduction
The type of insurance you qualify for will depend on the risk you pose to an insurer, in terms of your probability of making a claim on your policy. People with a high degree of risk will often find it difficult or costly to access traditional/private medical insurance. There are certain factors which insurers will look at to determine you’re the degree of risk you pose. Some factors are controllable, while other may be completely out of your hands. Fortunately, there is an option for people with serious or chronic to access health insurance, known as high risk medical insurance. Here are some the factors that revolve around insurance high risk medical policy.
History
Risk Factors
Like any other type of insurance, health insurance is based on risk. The less risky a client is, the more attractive they will be to most insurers. Therefore, most insurance companies will offer the most comprehensive and lowest priced policies to those individuals they deem as very healthy. Fortunately, people with chronic or serious medical conditions can still access health insurance through insurance high risk health insurance. However, due to the risk involved, most insurers will provide such policies at a premium.
High Risk Insurance Pools
Every state will run a high risk subsidized pool to make it more affordable for individuals with high insurance medical costs to access health insurance. This type of insurance is built to cater mainly for the self-employed individuals and small companies who may it difficult to service the cost of high risk private medical policies. The can either be run at a state or federal level. In most States, high risk pools will run independently with their own boards and administrators, but in some States they will operate under the State’s department of insurance. You can apply for this type of medical policy through an insurance agent or directly through a State agency.
Features
Qualification Requirements
In order for you to qualify for an insurance high risk pool, you should be a resident of the state you are applying in. you should also be able to prove that you have been denied for regular health insurance and that cost of your current premiums exceed the premiums of the high risk insurance pool. Individuals, who have been denied access to certain medical services or payment by the insurer due to a preexisting condition, are eligible for high risk insurance pools. However, in some States certain medical conditions and diseases are exempted from applying for a high risk pool.
Tips and comments
Coverage Provided
The level of coverage provided by an insurance high risk pool is very similar to the coverage offered by ordinary health insurance offerings. It is typically a comprehensive major medical plan, with a range of deductibles. Most pools will provide coverage for maternity, prescription drugs, mental health and substance abuse, among others.
The Cost of High Risk Insurance
The cost of obtaining high risk pool coverage is typically higher than traditional individual insurance. However, state laws will put a cap on the risk pool insurance rates, typically at 125-150% of the base individual market rate.
