HIV: PRACTICAL MATTERS-FINANCING MEDICAL CARE: PRIVATE, THIRD-PARTY PAYERS FOR FINANCING HEALTH CARE-UNINSUTABILITYAbout 8 percent of the applicants for individual plans are denied. Those whose applications are denied include virtually all people with AIDS, cancer, coronary artery disease, and diabetes. This and other health-related information obtained by insurers is recorded in the Medical Information Bureau in Boston, an insurance industry clearinghouse. Most people with preexisting conditions will find their access to individual insurance coverage limited unless that coverage comes through what is called an exclusion rider or unless they pay extremely high premiums. People unable to purchase insurance because of preexisting conditions may have access to high-risk pool insurance at inflated prices. Pool policies are provided in twenty-three states. Requirements for eligibility include residency in the state for at least six months and a notice from an insurance company of rejection, of a high-risk rate, or of an exclusion rider. Problems with the pool policies are that only twenty-three states carry them, that waiting lists are long, and that premiums are high. Information about pool policies can be obtained from state insurance departments. Another option is the open enrollment policies periodically available in some Blue Cross/Blue Shield plans in thirteen states. Open enrollment means that any applicant, including anyone with AIDS, is granted insurance regardless of health status. Not surprisingly, the premiums are higher, the waiting period for preexisting conditions is longer, and some preexisting conditions have limits on their coverage.*206\191\2*
HIV: PRACTICAL MATTERS-FINANCING MEDICAL CARE: PRIVATE, THIRD-PARTY PAYERS FOR FINANCING HEALTH CARE-UNINSUTABILITY
About 8 percent of the applicants for individual plans are denied. Those whose applications are denied include virtually all people with AIDS, cancer, coronary artery disease, and diabetes. This and other health-related information obtained by insurers is recorded in the Medical Information Bureau in Boston, an insurance industry clearinghouse. Most people with preexisting conditions will find their access to individual insurance coverage limited unless that coverage comes through what is called an exclusion rider or unless they pay extremely high premiums.
People unable to purchase insurance because of preexisting conditions may have access to high-risk pool insurance at inflated prices. Pool policies are provided in twenty-three states. Requirements for eligibility include residency in the state for at least six months and a notice from an insurance company of rejection, of a high-risk rate, or of an exclusion rider. Problems with the pool policies are that only twenty-three states carry them, that waiting lists are long, and that premiums are high. Information about pool policies can be obtained from state insurance departments.
Another option is the open enrollment policies periodically available in some Blue Cross/Blue Shield plans in thirteen states. Open enrollment means that any applicant, including anyone with AIDS, is granted insurance regardless of health status. Not surprisingly, the premiums are higher, the waiting period for preexisting conditions is longer, and some preexisting conditions have limits on their coverage.
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