Missouri Individual Health Insurance
Health insurance is the key to your financial woes springing out of costs associated with medical mishaps. If you don't get group health insurance through your employer, then you should look into purchasing Missouri individual health insurance from a private insurer. Finding out more about the rules and regulations regarding these individual health insurance plans in Missouri is your first step to deciding if this option is right for you.
Eligibility: How Am I Evaluated?
The state of Missouri has no regulations regarding how individual health insurance applicants are evaluated and leaves the decision up to each individual insurer. Most insurers choose to use popular factors, such as health status and age, when determining whether or not to approve or deny an applicant for a private policy. Aside from HIPPA eligible individuals, there also are no laws or regulations on why an applicant can be turned down by an insurer. You can basically be denied for any reason and the decision is up to the sole discretion on the insurer.
In accordance with HIPPA Group-to-Individual Portability Coverage regulations, Missouri guarantees issuance of private insurance to HIPPA eligible consumers. Missouri Health Insurance Pool (MHIP) is designed for individuals unable to obtain individual health insurance coverage due to their high risk health status.
Missouri Guaranteed Benefits & Pre-Existing Conditions
Missouri law does not require insurers to carry standardized policies for consumers to choose from, but they do require the coverage of certain benefits by all insurers under all plans. These benefits include services such as patient care for clinical cancer trials, screening for cervical, prostate, breast and colorectal cancer, diabetes care, care for pregnant women, vaccinations for children, contraceptives and hearing screening for newborns.
In Missouri, HIPPA eligible consumers cannot have pre-existing condition clauses imposed against them. For those who are not HIPPA eligible, an insurer can protect themselves from a pre-existing condition in one of two ways. First, they can look for pre-existing conditions in your medical history and add them to your elimination rider before your policy takes effect. This can exclude the condition from the policy indefinitely. Secondly, if you make a claim for a condition within the first 24 months of your policy, your insurer can look back at your medical history to see if the condition pre-existed. If so, they can deny your claim. They no longer reserve this right after your policy is over 24 months old. In addition, Missouri health insurers are obligated to provide same coverage limits and maximums as physical conditions to mental health conditions.
Missouri Individual Health Insurance Premiums
What you are charged for a Missouri individual health insurance policy is up to the insurer. Factors that many insurers take into consideration include age, health status, plan type, and family size. Insurers can use any of these factors to quote you a higher premium rate. There are no limits under Missouri law on how much you can be charged for a policy and you may encounter premium increases upon renewal due to any of these factors as well. Your insurance policy cannot be cancelled by your insurer because of declining health or the amount of claims made against the policy. You are guaranteed the opportunity to renew your policy, no matter what your health status may be at the time. However, you must also be willing to accept any premium increases imposed by the insurer to make up for these increased risk factors.
When looking for health insurance alternatives in Missouri, 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 help you in choosing a health coverage option perfect for you and your family.
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