When you buy individual health insurance in Kentucky, you could be turned down due to a pre-existing condition. In such situations, you can apply for coverage under the PCIP program.
Most Kentucky residents are covered by an employer-sponsored group
health plan. If you are not covered by such a plan, you can buy health
insurance from a private health insurance company. In this case, your
health status could determine your ability to purchase individual health
insurance Kentucky. In other words, private companies selling health
plans could turn you down because of your existing and past health
status. However, there are certain exceptions to this rule.
When
You Cannot Be Refused KY Individual Health Insurance
•
You cannot be refused coverage because of genetic conditions or because
of the results of a genetic test and your family’s health history.
•
If you are HIPAA eligible, you are guaranteed the right to buy individual health insurance Kentucky
coverage of some kind only from Kentucky Access with no pre-existing
condition exclusion periods. Under Kentucky Access you have three plan
options – one fee-for-service (FFS) plan and two preferred provider
organization (PPO) plans, all with varying deductible choices. Coverage
includes hospitalization, surgical expenses, doctor visits, preventive
care, maternity services, and home health care. You can add on enhanced
coverage for prescription drugs and mental health/substance abuse for an
additional premium.
• In KY, a newborn baby is
automatically covered under the parents’ individual health insurance Kentucky plan
for the first 31 days. To extend this coverage, the parents may have to
enroll the newborn in the plan and pay the premium within the 31 day
period.
• Kentucky health insurance law allows mentally
retarded and physically disabled dependents to stay on their parents’
health plan after they reach the age at which dependent coverage is
usually terminated, if certain conditions are met.
Kentucky
Health Care Coverage through the PCIP Program
Kentucky
residents with pre-existing conditions are eligible to apply for
coverage through the Pre-Existing Condition Insurance Plan (PCIP)
program run by the U.S. Department of Health and Human Services.
Conditions to qualify for coverage:
• You are a citizen
or national of the United States or lawfully present in the United
States.
• You must have been uninsured for at least the
last six months before you submit your application.
• You
must have a pre-existing condition or have been denied coverage because
of your health condition.
Under the PCIP program, you are
eligible for several health benefits such as primary and specialty care,
hospital care, and prescription drugs, which are available to treat
even preexisting conditions. Monthly premiums vary according to age and
options which come under three heads - ‘Standard’, ‘Extended’, and HSA.
Individual
Health Insurance Kentucky – Other Costs for Individuals with
Pre-existing Conditions:
During the year 2011, you have
to pay other costs too, such as a $1,000 to $3,000 deductible, which
varies by plan. The deductible pays for your covered health benefits
(excluding preventive care) before you plan begins to pay. Your plan
could have a separate drug deductible option.
After your
deductible, other payments would include: a $25 copayment for doctor
visits, $4 to $40 for most prescription drugs, and 20 percent of the
costs of any the benefits your plan covers. The maximum amount of your
out-of-pocket costs is $5,950 per year. If you opt for out-of-network
care, you could end up paying more for all these services.
