Individual Health Insurance
With a wide variety of available health insurance plans, residents of Kansas must carefully research their options before choosing a health plan. If you are a resident of Kansas, Health Plan One can help you tailor a plan that meets your specific needs. In 2004, 6% of Kansas residents were covered under individual health insurance. According to www.ahip.org, only 40% of small group employers offered health insurance coverage to their employees in 2005, forcing many workers to apply for individual health insurance. According to www.familiesusa.org, from 2000 to 2006, family health insurance premiums for workers in Kansas rose 5 times faster than incomes. On average, family health insurance premiums rose by 78.5%, while median earnings rose by only 15.6%.
There are various individual health insurance policies available in Kansas, therefore, consumers must research carefully for the plan that meets their needs. Medical underwriting is allowed without restriction. Medical underwriting is the process that allows insurance companies to review the medical history of prospective members. There is a 12 month look back and 24 month exclusionary period limit for preexisting conditions.
High Risk Pool
There is a high risk pool in Kansas called the Kansas Health Insurance Association (KHIA), for the medically uninsurable. You may be medically or federally eligible for this pool. To be medically eligible you must be a resident of Kansas for at least 6 months, have been denied coverage by two carriers, or allowed coverage with exclusions or at a rate that is higher than the pool, or have lost coverage due to something other than failure to pay premiums, and are not eligible for another insurance including Medicaid and Medicare. To be federally eligible you must have had at least 18 months of credible coverage or more with a group plan, be ineligible for Medicare or Medicaid, not be covered by any other insurance, your last coverage was not ended due to failure to pay premiums or fraud, and you have exhausted COBRA options.
Coverage under KHIA includes the following: doctor visits, prescription drugs, outpatient and in-hospital care, maternity, ambulance, labs and x-rays, skilled nursing care, hospice, home health visits, transplants, rehabilitation, durable medical equipment, mental health and substance abuse, physical, speech and occupational therapy, and preventive care.
Uninsured Kansans
According to www.statehealthfacts.org, 11% of Kansans were uninsured in 2004. In 2001, the highest rate of uninsurance in Kansas was 19.8% for young adults between the ages of 19 and 24.
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In 2005, Kansas ranked 25th in percent of employers offering health insurance. In 2006, the average monthly premium for an individual in a small group was $299, while the average monthly premium for a family was $785. (www.ahip.org)
In Kansas, medical underwriting is allowed with a variance of plus or minus 25% 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 3 month exclusionary period for those that did not have prior medical coverage. |
Medicaid is a state/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.
Income requirements:
Covered Services
Physical health services-office visits, regular checkups, immunizations, hospital services, inpatient and outpatient hospital, lab and x-ray, prescription drugs, eye doctor exams and glasses, hearing services and speech, and physical and occupational therapy, dental health services for children-checkups, cleanings, sealants, x-rays and fillings, mental health services-inpatient and outpatient mental, behavioral and substance abuse services.
Co-Payments
There are no co-pays for children under 19 years of age. Co-pays for adults vary.
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