Montana Individual Health Insurance
Health insurance is a crucial precaution that no person or family should be without. If you don?t get group health insurance through your employer, then you should look into purchasing Montana individual health insurance from a private insurer. If you are considering this route, you may have a lot of questions about the laws in Montana regarding private policies. The information below will seek to help you learn more about individual health insurance policies, the Montana laws surrounding them, and any rights that you may have.
Eligibility: How Am I Evaluated?
In Montana, individual health insurance applicants are evaluated based on a number of factors, including age and health status. You can be turned down for private health insurance based on any of these factors; the only exception is for newborns born to a coverage individual.
In response to HIPPA Group-to-Individual Portability Coverage regulations, Montana offers guaranteed acceptance from the Montana Comprehensive Health Association (MCHA). This coverage will be offered without a pre-existing exclusion period and with limits on how much you can be charged.
Montana Guaranteed Benefits & Pre-Existing Conditions
Montana requires that insurers offer one standardized policy to choose from. This is a bare-minimum policy which provides limited coverage. Stipulations on the policy include:
- A 50% co-insurance
- $1,000 deductible
- A stoploss of $5,000
- Lifetime maximum benefit of $1 million
- Exclusion of some benefits normally required by Montana law of all other insurance policies
As for other insurance policies, there are some benefits that must be covered under Montana insurance regulations, including durable medical equipment, hospital services, and professional services.
The laws in Montana allow health insurance providers to apply both an exclusionary period (not to exceed 12 months) for pre-exiting conditions and/or list them on an exclusion rider, which will exclude them from the policy permanently. Insurers can look back up to 3 years prior to your health insurance application to determine what, if any, pre-existing conditions you may have. Pregnancy is also considered a pre-existing condition under many policies.
Montana Individual Health Insurance Premiums
Montana individual health insurance premiums are determined based on many factors, including your age and health status. There are no restrictions or limits on what you can be charged and those with a health condition will likely be charged much more than healthy customers. When it is time to renew your policy, your premium can be raised due to increasing age and/or declining health.
Lastly, all policies, with the exception of disease-specific policies, are guaranteed renewable under Montana law. This means that you are guaranteed the ability to renew your policy regardless of any change in your health status; however, since your insurer has the right to raise your premium, you may also wish to see what other plans are out there before you renew.