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Health Insurance Risk Pool
- Health Insurance High Risk Pools are available for people who have been denied Health Insurance coverage because of a preexisting medical condition.
- More than a quarter of a million people have been provided coverage with a comprehensive health insurance program through Risk Pools in over 30 states.
- High Risk Pools are created by the different states and do not require tax dollars in order to operate normally.
- Risk Pools provide coverage for individuals to fill the gap or void in coverage due to not being able to qualify due to a Preexisting Medical Condition.
State Health Insurance Risk Pool Websites (updated 7/26/2006)
These are the state Health Insurance High Risk Pools available and their websites.
- Alabama Health Insurance Plan
- Alaska Comprehensive Health Insurance Association
- Arkansas Comprehensive Health Insurance Plan
- California Major Risk Medical Insurance Program
- Connecticut Health Reinsurance Association
- Cover Colorado
- Idaho Individual High Risk Reinsurance Pool
- Illinois Comprehensive Health Insurance Plan
- Indiana Comprehensive Health Association
- Health Insurance Plan of Iowa
- Kansas Health Insurance Association
- Kentucky Access
- Louisiana Health Plan
- Maryland Health Insurance Plan
- Minnesota Comprehensive Health Association
- Mississippi Comprehensive Health Insurance Risk Pool Association
- Missouri Health Insurance Pool
- Montana Comprehensive Health Association
- Nebraska
- New Hampshire Health Plan
- New Mexico Medical Insurance Pool
- Comprehensive Health Association of North Dakota
- Oklahoma Insurance Department High Risk Pool
- Oregon Medical Insurance Pool
- South Dakota Risk Pool
- South Carolina Health Insurance Pool
- Phone 1-800-868-2500, ext. 42757, or 1-803-788-0500,
- ext. 42757
- Tennessee Tenncare Program
- Texas Health Insurance Risk Pool
- Utah Counties Insurance Pool
- Washington State Health Insurance Pool
- Wisconsin Health Insurance Risk Sharing Plan
- Access West Virginia
- Wyoming Health Insurance Risk Pool
Who can participate in a state high risk pool?
Residency
- Anyone applying for health insurance plan coverage through the risk pool must reside in that state.
Proof of one of these:
- Proof of rejection - Individuals have to prove that they have been rejected for health insurance coverage by at least one insurer.
- Currently Insured with a higher premium. - One of the conditions of eligibility is if and individual is paying a higher premium than the high risk pool's plan.
- Currently insured with a rated policy or a rider. - Another condition of eligibility is if an individual is currently insured but has a rider for a medical condition or if he or she is rated.
Who is not eligible for a high risk pool plan?
Non-Resident
- An individual is not eligible for the risk pool if he is not a resident of the state.
Eligible for Medicare of Medicaid
- Several of the state run high risk pool plans do not allow an individual to apply for coverage if he or she is eligible for or is currently receiving Medicare or Medicaid.
- Many states do, however, offer a high risk plan for the Medicare eligible individual.
Termination of Benefits
- One is not eligible for risk pool health plan coverage if he or she terminated coverage in the plan already and at least 132 months have passed since such coverage was terminated.
Extended Lifetime Benefits
- One is no longer eligible for risk pool plan coverage if her or she has reached the maximum benefit level offered by the plan.
Inmates
- One is not eligible to participate in the risk pool plan coverage if he or she is an inmate of a public institution.
Specific Exclusions
- Some states exclude coverage for certain medical conditions or diseases.
Enrollment Cap
- Many states have capped enrollment in their plans.
- In this case the plan will only allow a certain number of individuals in their plan at any one time.
- Those over the enrollment cap are usually placed on a waiting list.
