Kentucky Individual Health Insurance
Health insurance is a necessity that financially protects you and your family against expensive medical disasters. For those considering Kentucky individual health insurance, the possibilities are endless, as there are often literally hundreds of plans to choose from. Since you are considering health insurance, you may want to know more about the Kentucky laws regulating individual health insurance policies.
Eligibility: How Am I Evaluated?
First, Kentucky applications are reviewed based on the criteria set forth by the health insurance provider. Most insurers use factors such as health status, gender, age, and lifestyle habits to establish whether to approve a health insurance applicant. Kentucky law has not mandated regulations on the denial of applications and an insurer can turn you down for any reason.
In accordance with HIPPA Group-to-Individual Portability Coverage regulations, Kentucky guarantees issuance of health insurance via Kentucky Access, the state's high-risk health insurance pool, to HIPPA eligible consumers who have been unable to obtain a policy from a private provider.
Kentucky Guaranteed Benefits & Pre-Existing Conditions
What your policy covers will depend on which plan you choose to buy; however, insurers are required to carry at least one standard benefit plan. The benefits for these plans will be the same for all insurers, only the price may vary. You can choose from a standard indemnity plan, a standard PPO plan, or a standard HMO plan. All of them offer comprehensive coverage for certain medical services such as hospital stays for new mothers, mammograms, diabetes care, and hearing aids for children. As in other states, Kentucky health insurance companies are also required to set coverage limits and maximums for mental health conditions equal to physical conditions. The standard indemnity plan requires that you pay a deductible (around $400 individual/$800 family) before you can start to receive compensation for your claims, which you must file yourself. There is a 10% to 20% co-insurance after the deductible. This plan also allows you to choose any hospital and physician you wish. On the PPO plan, your deductible will vary depending on if you choose in-network ($400 individual/$800 family) or out-of-network ($700 individual/$1,400 family) providers. After you have paid your deductible, you will then only be responsible for 20% to 40% of your care-related costs. The HMO plan only allows you to receive services from in-network providers. Although this is restrictive, it comes with no deductible and a mere $10 to $20 co-payment per visit.
In Kentucky, an insurer can impose an exclusionary period on any suspected pre-existing conditions for up to 12 months, after reviewing your medical history for the last six months before coverage begins. They cannot, however, add an elimination rider to your policy, which would have excluded certain conditions indefinitely.
Kentucky Individual Health Insurance Premiums
Premiums are based on internal rules and regulations of your insurer. Your insurer will take many factors into consideration when determining your rate, including age, gender, health, and plan type. There are no laws that regulate how much you can be charged for an individual health insurance policy in Kentucky. However, health insurance plans in the state are guaranteed renewable, so your insurer cannot cancel your policy because you got sick. They may, however, raise your premiums to offset these costs.
When looking for health insurance alternatives in Kentucky, it is crucial to have an idea of the coverage details and the costs of owning a health plan that you are particularly interested in. Contacting a qualified broker/agent can aid you in choosing a health coverage option perfect for you and your family.