South Dakota Individual Health Insurance
Health insurance is a significant protection that should be considered a necessity by every person and every family. If you don't get group health insurance through your employer, then you should look into purchasing South Dakota individual health insurance from a private insurer. There are laws and regulations in South Dakota surrounding these individual health insurance policies that you should be aware of, in order to make a more informed decision.
Eligibility: How Am I Evaluated?
Generally, health insurance applications are not regulated by the state and applicants can be denied for any reason. Insurers in South Dakota have the flexibility to evaluate each applicant based on factors defined by their own rules and regulations. These factors may include age, number of people seeking coverage under the policy, and past medical history.
In compliance with HIPPA Group-to-Individual Portability coverage, South Dakota guarantees acceptance into the South Dakota Risk Pool (SDRP), the state's high-risk health insurance pool, for those who are HIPPA eligible and have been turned down by private health insurance providers.
South Dakota Guaranteed Benefits & Pre-Existing Conditions
The state of South Dakota does not require insurers to carry any standardized policies. The law does require all insurers to cover certain benefits on all plans, for every individual. These benefits include diabetes treatments and prostate cancer screenings.
The individual health insurance laws in South Dakota allow an insurer to look back over your past medical records to determine if there are any pre-existing conditions. Any condition that you sought medical treatment or advice for can be determined as pre-existing. The insurer can then impose a 12 month exclusionary period on these conditions, after which the conditions will then be covered under your plan.
Additionally, an insurer may choose to add the condition to the elimination rider attached to your policy, which will exclude the condition from coverage for the length of the policy. If you file a claim within the first 2 years of your policy for a condition that is not listed as a pre-existing condition, your insurer has the right to take another look over your medical history to determine if the condition should have indeed been listed as a pre-existing condition. If they determine that it was pre-existing, they have the right to deny your claim.
South Dakota Individual Health Insurance Premiums
South Dakota allows insurers to determine their own policy rates, based on your health, age, lifestyle choices, or any other factors; but there are also 'ceiling' limits on how much an insurer can reasonably charge you. Even still, you may receive a relatively high premium quote depending on these factors. Your insurer also has the right to raise your premium at renewal to compensate for risk factors, such as increasing age.
Lastly, insurance policies in South Dakota are guaranteed renewable. This means that you have the guaranteed right to renew your policy at the end of its term, even if your health status has declined or you have incurred expensive medical bills. Keep in mind though, that your insurer may also be able to raise your premium in order to offset these risks and costs.