Alabama Health Insurance - Health Plan One

Health Plan One	START BELOW OR CALL 877.56 PLANS (877)567-5267
Health Insurance for the Well Informed

Today in Alabama, the number of uninsured adults (age 19-64) has reached 544,321 about 19% of the state's population. In a six year period from 2000-2006, family health care premiums rose by 80.7% while family earnings rose only 13.1%. Individual coverage premiums also rose from $547 to $850 an increase in 55.4%. Because of statistics like these, it is important that you perform adequate research before finding the most affordable and best health insurance plan.

The state of Alabama does not require health insurers in the individual market to sell standardized policies. Insurers can design different policies so it is important to read and compare different health insurance plans very carefully. However, Alabama does require all insurers to cover certain benefits such as post delivery hospital stay and breast cancer screening. The process of medical underwriting is allowed in Alabama without restriction. This process allows insurance companies to review the medical history of prospective members. For preexisting condition requirements, the company may look back in a consumer’s medical history 60 months and impose a 12 month exclusionary period for any preexisting conditions.

Eligibility for high-risk health insurance includes being an Alabama resident and having at least 18 months of continuous health coverage with no lapse greater than 63 days.

Coverage under high-risk health insurance includes:

Out-patient and In-patient Hospital Care

Durable Medical Equipment

Mental Health and Substance Abuse

Alabama also offers The Alabama Health Insurance Plan. The AHIP offers coverage to HIPPA-eligible people. Those who are HIPPA-eligible have left job-based coverage and have elected and exhausted COBRA continuation coverage. AHIP is designed to provide permanent coverage options for people who cannot find health insurance after leaving their job.

In Alabama, a group or small business is considered to be 2-50 employees. As of 2006, the single average premium was $297 and the family average monthly premium was $777. For small business health insurance in Alabama, benefits will vary depending on the chosen plan and if you were uninsured for a previous 1-6 months, a waiting period for coverage of pre-existing conditions may apply.

Similar to individual health insurance in Alabama, medical underwriting is allowed with group insurance. Rates may vary by plus or minus 20 percent of the indexed rate based on the health status of the group. For preexisting condition requirements; the carrier may look back in a consumer’s medical history 6 months and impose a 12 month exclusionary period for those that did not have prior medical coverage. However, group plans cannot apply a pre-existing exclusion period for pregnancy, newborns, newly adopted children, children placed for adoption, or genetic information.

There are several factors that determine eligibility of an employee for guaranteed coverage.

These include:

Company size: 2-50 employees
Two employees must work for at least 6 months out of the year, and work 20 hours per week for coverage
Owner can count as an employee
Owner name on business license must draw wages from the company

From www.coverageforall.org

Alabama offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. COBRA requires an employer who employs more than 20 people to offer continued group insurance coverage to former employees and their dependents for up to 18 months.

To be eligible for COBRA coverage, you must have been enrolled in your employer’s health insurance plan when you worked and the health plan must continue to be in effect for active employees. COBRA continuation is available upon the occurrence of a qualifying event such as job loss, reduction in hours worked, death, or divorce.

Medicaid is a joint state and federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children
Ages 1-5: 133% of the Federal Poverty Level
Ages 6-19: 100% of the Federal Poverty Level
Pregnant Women and Infants
Pregnant Women: 175% of the Federal Poverty Level
Infants - Ages 0-1: 133% of the Federal Poverty Level
Parents
Non-Working Parents: 13% of the Federal Poverty Level
Working Parents: 19% of the Federal Poverty Level
Other Populations
Supplemental Security Income Recipients-74% of the Federal Poverty Level

Dental, doctor, eye care, family planning, hearing, home health, hospice, inpatient and outpatient hospital care, laboratory and x-ray, maternity, mental health, nurse midwife, nursing home, prescription drugs, renal dialysis, transplant, transportation, and well-child visits.

These range from 50 cents to $3.00 for office visits and prescription drugs. There is a $50 co-payment for each inpatient hospital stay. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

In Alabama, the children state health insurance program is Allkids. Allkids provides health insurance coverage for children younger than 19. The program is made for kids whose family earnings are too high to qualify for Medicaid but not enough to purchase individual health insurance. The price of Allkids is usually $50-$100 per child annually, but may vary depending on family earnings. Please visit the ALL Kids website for more detailed information at: http://www.adph.org/allkids/