The Difference Between State Mandates to Cover and to Offer Infertility Insurance Coverage

Out of the 15 states that have mandated coverage of infertility in health insurance policies, only California and Texas have mandates to offer coverage in health care policies. What this means to a couple dealing with infertility is that their employer has the option to purchase health insurance that offers some coverage for infertility testing, diagnosis and treatment, but they are not required to buy such insurance.

There are many factors that go into the choice of which insurance policy or policies to purchase and offer to employees, price being one of them. If you live in California or Texas and your employer’s choice of insurance coverage does not include any infertility coverage, you should talk to your human resources manager or the manager of benefits and find out if it would be possible to have the company offer additional health insurance policy options with at least one of them offering infertility coverage.

The company may not want to offer such insurance if their costs will be going up, especially if they believe that only one or two employees want such coverage. So go a little grass roots and find out if your co-workers would be willing to pay more for such coverage, and ask them all to ask for it as an option in future insurance offerings. You may be surprised at how many co-workers would like such coverage and your company may surprise you and offer additional choices in insurance coverage in the future.

That leaves us with 13 states, listed just below along with some information, that have mandates to cover. Depending on the wording of the law for each state, health insurance policies and/or HMOs that offer anything from basic coverage to maternity coverage, must also cover some infertility testing, diagnosis and treatments. Basically, a mandate to cover is just that, they must cover “something” where infertility is concerned and many of the state laws state specifically what must be covered too.

  • Arkansas – HMOs and self-insurers exempt; all individual and group policies that cover maternity must cover
  • Connecticut – Self-insurers and religious organizations exempt; all individual and group policies must cover
  • Hawaii – Self-insurers exempt; all individual and group policies must cover
  • Illinois – Self-insurers, religious employers, and companies with fewer than 25 employees exempt; all group and HMOs that cover pregnancy must cover
  • Louisiana – Self-insurers exempt; cannot exclude coverage just because condition results in infertility
  • Maryland – Self-insurers, religious employers, and companies with fewer than 50 employees exempt; all individual and group policies that cover pregnancy must cover
  • Massachusetts – Self-insurers exempt; all insurers that cover pregnancy must cover
  • Montana – Self-insurers exempt; HMOs required to cover as basic health care
  • New Jersey – Self-insurers, religious employers, and companies with fewer than 50 employees exempt; group insurers and HMOs that cover pregnancy must cover
  • New York – Self-insurers exempt; group policies must cover testing and diagnosis
  • Ohio – Self-insurers exempt; HMOs required to cover as basic health care
  • Rhode Island – Self-insurers exempt; individual and group policies and HMOs that cover pregnancy must cover
  • West Virginia – Self-insurers exempt; HMOs required to cover as basic health care

A state mandate to cover means that unless a business’s group, and in some cases individual, health care insurance is exempt, some form of infertility coverage must be included in the policy. On the flip side of the issue is the state mandate to offer, which only means that the insurance company has to offer for sale a policy that includes infertility coverage, but the business is not required to purchase that coverage. Knowing not only what your insurance policy states is covered, but also what your state’s mandate is, can help you when navigating the world of infertility and insurance coverage.

Review of Car Insurance Coverage For Uninsured and Under-Insured Motorists in the US

Car insurance coverage comparison is becoming very popular in USA. The economic downturn is bringing about unexpected changes in most walks of life and insurance is one of them. As per the Insurance Information Institute one driver out of every seven in the US is believed to have no automobile insurance. This would mean that 14% of the drivers are uninsured and only 86% drivers are insured. The drivers who are going for insurance have to face broad repercussions which arise out of uninsured motorist coverage. Car insurance comparison becomes very important for those who are taking insurance to verify whether they have taken the uninsured motorist and under insured motorist.

The uninsured motorist and under-insured motorist insurance is separate, although in many states they can or must be purchased together. They are also better known in abbreviated form as UM or UIM. It is natural that you would not think about or know exactly what the uninsured or under insured motorist indemnity is, unless you fall into such a situation. If you have opted for uninsured motorist than this will pay you for any loss or damage you may incur when you have a hit-and – run accident or when you collide with an uninsured motorist. A motorist can be uninsured when he has no insurance coverage, or whose claim the insurance company denied or was not able to financially meet with the obligations of loss. The uninsured motorist indemnity will also protect you if you are hit by a car as a pedestrian.

The under-insured motorist coverage pays you for any loss or damage when the motorist with whom you have collided is under-insured. The motorist in this case is insured but his limits of insurance are lower than the actual loss you have sustained. These coverages will pay you and your passengers for any bodily injuries are caused when the under-insured motorist or uninsured motorist is legally liable for this. In certain states the coverage for property damage is also paid under this coverage. Both these insurance pay you for your medical bills, reimburse for the lost wages if you miss work and you can also seek redress for pain and suffering resulting from the crash.

In 12 states the no fault insurance laws are prevalent. The no-fault insurance coverage is very similar to the uninsured motorist coverage. No-fault coverage gives certain compensation when you are not at fault and the driver at fault is uninsured. You can collect the benefits from your own insurance companies. Nevertheless, in the states where no-fault law prevails, going for uninsured motorist coverage is cost effective and beneficial since it provides an additional layer of financial support. Accidents can turn out to be more ghastly or long lasting than what they seem at first.

Only five of the states that insist their drivers carry Uninsured Motorist also mandate the purchase of this coverage; they are: Connecticut, Maine, Minnesota, North Carolina and Vermont. If you live in any state other than those that have compulsory coverage, a prudent person like you should go for car insurance coverage and buy under-insured and uninsured motorist coverage. The cost for this car insurance coverage of uninsured motorist is quite nominal. This is a very positive factor to consider when taking this coverage. With a little extra cost you can save yourself from any financial problems at a later date. In these economic times if would serve you since many drivers are either uninsured or under-insured.

You should compare car insurance coverage and if you do not have this coverage you can seek to take this coverage. Compare car insurance quote for the best coverage and rates. It always pays you to be alert and make informed decisions when it comes to car insurance.

Denied Individual Health Insurance Coverage? Reasons For Health Insurance Coverage to Be Denied

What should you do if you have been denied health insurance coverage? What options do you have if you have been denied individual health insurance coverage? What are some of the common reasons that health insurance coverage can be denied?

In a nutshell, if you have been rejected individual health insurance coverage due to pre-existing conditions then you should first of all shop around and compare rates from multiple companies. After all, different health insurance companies have different underwriting guidelines and just because you have been denied coverage with one company does not necessarily mean that the next company will do the same. Having the services of an experienced independent health insurance agent at a time like this is a definite plus.

If for any reason you are rejected from receiving health insurance by a company, you may also want to try to look for companies that don’t require you to answer questionnaires, or even better go for some that can give you at least a little coverage for a low-cost – this is a last option though as almost all individual plans that do not have medical underwriting are really just discount plans in disguise and will not give the coverage that a true major medical comprehensive health insurance plan will.

Some states (29 to be exact) have what are called high risk pools. These were created to serve those people that are considered medically uninsurable or those that are described as a “high risk” for the insurance companies. What these pools do is give those people that have been turned down an opportunity of having health insurance. With a high risk pool you will never be turned down for any reason and the best part is that it will help you pay for large medical costs.

There are however, a bunch of things that might be viewed as disadvantages to the customer deciding whether or not to consider a high risk pool. Some of the disadvantages include that the state can terminate your coverage if there is legislation against it, there are usually long waiting lists, the cost is much higher than private health insurance plans and you can lose eligibility if you move or if you start receiving Medicare and Medicaid. If you want to know if your state is one of the 29 that offer “high risk” pools or for more contact information to enroll in one of them then you should speak with a health insurance broker local to your state. Again, keep in mind that a high risk pool should be one of the last options that you consider.

With the Health Insurance Portability and Accountability Act (HIPAA) passed in the year 1996, new doors were opened for the people that weren’t able to qualify for private individual health insurance. Within this act a law was passed that states that a person cannot be denied health insurance for any reason if they decide to join a group health plan. This means that if you have a job with an employer that offers group health insurance coverage, more than likely you won’t be denied coverage. The only way in which coverage wont be given to a person in the even that they seek group health insurance, is in the event that you do not meet the eligibility requirements of your employer.

Some of those eligibility requirements could be the total number of hours you work per week and whether you have a salaried or an hour employee. It is of note to highlight that group health plans may refuse to cover a person with pre-existing conditions; however if you have at least 12 months of continuous creditable coverage, a group plan will not be able to deny you insurance due to pre-existing conditions.

This doesn’t mean that if you have had health insurance in the past and you have a pre-existing condition you are covered. If you have had a break in coverage (lapse in coverage) and you apply for group coverage you will be given an exclusion period. During this exclusion period the insurer will not pay for any treatment or doctor visits related to your pre-existing conditions, instead you will be responsible for all unrelated treatment.

The HIPAA laws also dictate that individual health insurance coverage must be issued on a guaranteed issue basis (everyone is approved) and all pre-existing conditions are covered if someone meets 6 criteria. These 6 HIPAA health insurance requirements are an important part of the HIPAA laws to understand if you have major pre-existing conditions and have been denied for regular individual health insurance coverage.