Once you have been labeled as "high risk", it is nearly impossible to get any type of health insurance.
If you can find a company willing to give you insurance, you will be paying a premium price. Many people can't afford high risk health insurance, so they are forced to go without coverage.
High risk Americans are people with serious health problems. These are the people that need health insurance the most, but are denied coverage because it will cost the insurance company too much money.
Insurance companies don't like to pay out. They like clients that are
strong, young and healthy, and will rarely make a claim.
Luckily, Americans with pre-existing health problems do have another option. They can join a high risk health insurance pool.
If you don't have health insurance coverage through your place of employment, and have been denied private coverage because of a pre-existing medical condition, you may be able to join a pool.
Insurance 'pools' are programs mandated by the state to ensure everyone has the health insurance coverage they need.
High risk health insurance pools were started by the state of Minnesota in 1976, and are now available in most states. An estimated 180,000 people are enrolled nationwide.
Typically, these pools are used as a last resort. Many people also use insurance pools to fill the gap in between group coverage from employers.
By pooling uninsured persons, states can help people get the health insurance they need, however premiums are quite high.
If you have a pre-existing health condition, you are considered "uninsurable" by normal insurance companies.
In order to minimize the amount of claims they have to pay out, insurance companies often refuse to cover anyone with a fatal disease, a chronic illness, or even someone who has too many routine check-ups.
These uninsured people may qualify for a high risk insurance pool, if they can afford the premiums. But being labeled uninsurable by other health insurance companies isn't enough to qualify for membership in a pool.
Each state has its own eligibility requirements. These requirements generally include proof that you live in that state, proof that you have been rejected by an insurance company, or proof that a claim for treating a pre-existing condition has been denied.
People who are eligible for Medicare, Medicaid, are on COBRA or in jail are not eligible for high risk health insurance pools. You could also be ineligible due to certain medical conditions.
Which conditions are not covered vary by state. The number of people allowed in the group is limited, and also varies by state.
If the pool in your state is full, you could be put on a waiting list. Depending on the length of the list, this could mean you will left without coverage for months, or longer.
Once you do get accepted into the plan, you might still have to wait for treatments. Many plans have a waiting period before they will cover treatments for some pre-existing conditions.
This waiting period is usually about six months, but can vary from one state to another. How long this waiting period is can also depend on the medical condition you need treatments for.
High risk insurance pools offer plans comparable to many of the big insurance companies, and have different premium levels and deductible amounts.
What is covered also varies, but most plans include prescription drugs, maternity care and treatments for diseases.
The downside is that these plans are expensive. The federal government does set aside some grant money to help fund high risk insurance pools, and some funding comes from revenue collected from hospital taxes, but most of the money comes from the premiums paid by members.
Because the members of these plans are more likely to use their insurance benefits than the general population, the premiums are higher than similar policies from private insurance companies.
Although state laws cap the rates, the caps on high risk health insurance premiums are generally about 200 percent higher than market value.