Posted on Wed, Oct 14, 2009
When it comes to providing financial security and medical well-being for your family, health insurance is vital. One medical emergency can drain a family's finances quickly, which is why purchasing the right
Kentucky individual health insurance plan is one of the wisest investments you can make. With a plethora of plans to choose from, it is important to understand the details regarding laws in Kentucky that regulate individual health plans.
As you consider the laws affecting your coverage, it is necessary first to understand your eligibility for certain insurance plans. In Kentucky, insurance applications are reviewed based on certain criteria determined by the insurer. It is typical for insurance companies to use determining factors including health, age, and lifestyle choices as they decide if they will accept a particular applicant.
The HIPPA Group-to-Individual Portability Coverage regulations that include the state of Kentucky guarantees issuance of health coverage. This coverage is provided through Kentucky access, which is the state's higher risk health insurance pool, to applicants who are HIPPA eligible and have been unable to secure an insurance plan through a private insurer.
Guaranteed Benefits & Pre-existing Condition Laws in Kentucky
The coverage one's policy provides is determined by the plan chosen. Insurers in Kentucky are required to carry at least one standard benefit plan in their products. These standardized plans like the HMO or PPO or indemnity plan provide uniform coverage, regardless of the insurance company offering it. The comprehensive coverage offered by these standard plans in Kentucky include:
- Hospital stays
- Preventative care
- Physician care
- Maternity services
- Immunizations
- Mental health services
- Prescription drug benefits
While the benefits are generally the same, the cost of these plans and the way they function vary. For example, the HMO plan allows the consumer to receive services only from in-network providers, but typically has no deductible and low co-payments. The PPO plan gives the consumer more options and the ability to select in-network or out-of-network providers. Out-of-network providers come with a higher out-of-pocket payment, but after the deductible is met, the consumer pays only 20 to 40% of the medical costs. On the other hand the indemnity plan requires a deductible before the claim payment kicks in and a 10 to 20% coinsurance after the deductible is met, but there is the freedom to choose any hospital or doctor. Additionally, the consumer is responsible for submitting all claims with the indemnity plan option.
As for pre-existing conditions for consumers in Kentucky, an insurer can enforce an exclusionary period on any identified pre-existing condition for up to a year, but elimination riders that exclude specific conditions indefinitely are prohibited.
What is There to Know about Kentucky Individual Health Insurance Premiums?
Premiums are determined based on the regulations and guidelines of the chosen insurance company. Kentucky does not have laws mandating how much one can or cannot be charged for individual health coverage. One benefit to Kentucky consumers is that health insurance policies have a guaranteed renewal policy, meaning an insurer cannot cancel a policy if health problems arise, although premiums may be increased to offset additional costs.
Kentucky Medical Insurance Quotes