Denial due to a pre-existing medical condition

High Risk Pool Plan*

ALABAMA* 

Alabama residents can contact the Alabama Department of Insurance to get health insurance information.   Alabama Department of Insurance, 201 Monroe Street, Suite 1700, Montgomery, AL  36104, (334) 269-3550. 

Alabama has the Alabama Health Insurance Plan.  Phone 1-800-513-1384.

ALASKA * 

Alaska residents can contact the Alaska Division of Insurance to get health insurance information.  The address is Insurance Consumer Services Section, Alaska Division of Insurance, Robert B. Atwood Building, 550 W. 7th Avenue, Suite 1560, Anchorage Alaska 99501-3567, (907) 269-7900.

The Alaska Insurance Code establishes the Alaska Comprehensive Health Insurance Association.  One provision of the health plan operated by the Association rules concerns:  

"Eligibility Requirements” - Coverage is available to persons under any one of three separate sets of rules:

Under the high risk rules a person is eligible for coverage if the person:

Ø      has been for the past 12 months and continues to be a resident of the State of Alaska;

Ø      is not eligible to be covered under a small employer (2-50 employees) health insurance plan;

Ø      is not eligible for medical coverage under a federal or state program including Veteran Health Benefits, Indian Health services or Medicaid or a group health plan,

Ø      does not have other health insurance  -and-  at least one of the following:  has received from at least one health insurer a notice of rejection for health insurance dated within the last six months;  has received restrictive riders that substantially reduce coverage;   has one of the conditions listed below. (see plan details for list)

Insurers transacting business in our state that provide a denial of health coverage to an applicant are required by Alaska Statute to provide the consumer a notice referencing the ACHIA plan as an option for coverage and providing the contact information for the plan.

Full information about the ACHIA Health Plan and participation rules are available on the world wide web at the following URL:  www.achia.com or phone 1-800-467-8725.

ARIZONA     

Arizona residents can contact the Arizona Department of Insurance to get health insurance information.  The address is Arizona Department of Insurance, 2910 N. 44th Street, 2nd Floor, Phoenix, AZ  85018-7256, (602) 912-8444 or (800) 325-2548.

ARKANSAS * 

Arkansas residents can contact the Arkansas Department of Insurance to get health insurance information.  The address is Arkansas Department of Insurance, 1200 West Third Street, Little Rock, AR 72201, (501) 371-2600 or 1-800-282-9134. 

Ask for a list of all the insurance companies that market major medical insurance in the state of Arkansas.  The list includes telephone numbers of each company so you can contact them personally to inquire as to their underwriting requirements for pre-existing.  Each company has their own restrictions/guidelines on how they approach pre-existing conditions.   

Phone for more information - Arkansas Comprehensive Health Insurance Program  (501) 378-2979.

CALIFORNIA * 

California residents should contact the California Insurance Department to get health insurance information.  California  web site is http://www.insurance.ca.gov/. 

Ø      Managed Risk Medical Insurance Program (MRMIP) - A person eligible for this Health Care program can be enrolled in the program for 36 months.  After that period, enrollees are given a one-time opportunity to purchase guaranteed health coverage.  For more information about MRMIP and other health insurance options, call the following telephone numbers:  916-324-4695 and/or 1-800-289-6574. 

Ø      The COBRA (Consolidated Omnibus Budget Reconciliation Act of 1996), CAL-COBRA, and/or HIPAA  (Health Insurance Portability and Accountability Act passed in 1996) may also be a health insurance option to research.  

Ø      Lower Income:  California Public Social Services may be an option to research.

COLORADO* 

August 13, 2006 update:  Unlike employer-sponsored group health benefit plans (this would also include the self-employed), which are issued on a guaranteed-issue basis (no health questions/underwriting), carriers marketing individual health plans may underwrite.  If an application for individual health insurance is rejected, or rated up /issued with an exclusion rider(s) due to health history/pre-existing condition(s), the applicant may be eligible for coverage through "Cover Colorado".   When carriers reject/decline coverage, or rate up/issue coverage with exclusion rider(s), the carrier is required to advise the applicant of Cover Colorado.  If the applicant is not eligible for group coverage (employer-sponsored, or self-employed), then Cover Colorado would be the most likely option for coverage. 

The website is located at URL www.covercolorado.org.   If they have been denied they would qualify here as long as they are Colorado residents.  We are a non-profit entity.  All of our information about Cover Colorado is on our website.  If you have any further questions you may contact our Special Services Representative at 303-863-1960.

Colorado residents can contact the Colorado Insurance Department to get health insurance information.  The address is Colorado Insurance Department, 1560 Broadway, Suite 850, Denver, CO  80202, telephone 303-894-7490 in the Denver-metro area and 1-800-930-3745 from other parts of the state.

CONNECTICUT *

Connecticut residents can contact the Connecticut Insurance Department to get health insurance information.  The address is Connecticut Insurance Department,   P.O. Box 816, Hartford, CT  06142-0816,  (800) 203-3447 or (860) 297-3800. 

Unfortunately there is no health insurance program in this state that specifically deals with denial of health insurance due to uterine fibroids.  Individuals with pre-existing conditions may apply to the Health Reinsurance Association for a guarantee issued policy but there is usually a 12-month waiting period for pre-existing conditions.   Phone 1-800-842-0004.

Our web site is www.CT.gov/cid.  That site enables an individual to obtain a list of the companies that write individual policies in this state.  It also gives the telephone number for the Health Reinsurance Association (HRA).

WASHINGTON, D.C.    

Washington, D.C. residents can contact the D.C. Insurance Department to get health insurance information.  The address is D.C. Insurance Department, 810 First Street, NE, Suite 701, Washington, DC 20002  (202) 442-7812.

DELAWARE       

Delaware residents can contact the Delaware Insurance Department to get health insurance information.  The address is Delaware Insurance Department, 841 Silver Lake Boulevard, Dover, DE  19904  (302) 739-4251.

FLORIDA*     

Florida residents can contact the Florida Department of Financial Services Consumer Helpline phone number is 1-800-342-2762 (between 8:00 a.m. and 7:00 p.m. - Eastern time) for health insurance information. 

An excellent brochure to ask for is “Health Insurance – A Guide for Consumers”, which is available from the Florida Department of Financial Services.   The Office of Insurance Regulation regulates insurance rates and forms in Florida

To obtain a free publication that explains COBRA in more detail contact U.S. Department of Labor at  Employee Benefits Security Administration, Miami District Office, 8040 Peters Road, Building H, Suite 104, Plantation, FL  33324.

Florida Mini-COBRA law provides similar continuation of coverage protection for employees who work for a company with fewer than 20 employees.  An employee must contact the insurer within 30 days of losing group eligibility, that he or she is eligible to continue coverage.

The Federal Health Insurance Portability and Accountability Act (HIPAA) – call the Consumer Helpline 1-800-342-2762 to find out what the options and state law is for HIPAA.

To verify an insurance company – contact the Florida Insurance Guaranty Association (FIGA) and the Florida Life and Health Insurance Guaranty Association (FLHIGA).  Call the service office in your area or 1-800-342-2762.

Florida Service Offices

GEORGIA      

Georgia residents can contact the Georgia Insurance Department to get health insurance information.  The address is Georgia Insurance Department, Two Martin Luther King, Jr. Drive, West Tower, Suite 704, Atlanta, Georgia 30334
Main Telephone: 404-656-2070, Toll Free: 800-656-2298

HAWAII      

Hawaii residents can contact the Hawaii Insurance Department to get health insurance information.  The address is  Hawaii Insurance Department, 335 Merchant Street, Honolulu, HI  96813, web site  InsHealth@dcca.hawaii.gov.

The State Department of Human Services have the MedQuest program, which may help, however there are qualifying criteria that must be met.  For more information please visit the MedQuest program at www.Med-Quest.us. or contact the Department of Human Services at (808) 586-5390.  The State Department of Health - they do have a program which will pay, for those who don't have insurance, for an evaluation, and in some cases for visits.  This is done by either contacting the State Department of Health or contacting a community health center.  For more information on how to use services provided  by the State Department of Health please visit their website www.state.hi.us/doh , or contact them at (808) 586-4400 or (808) 586-4442.