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Understand your options for Arizona health insurance
One of the biggest
changes in Arizona health coverage under the provisions
of the Health Reform Act is that “child only” coverage
is no longer being offered and won’t be in the
foreseeable future. This probably accounts for 10-20% of
the policies written for pre-65 Arizona health insurance
so it’s a pretty big deal and the fact that it pertains
to children makes it even more pressing as an issue.
The reason? Under health reform, Arizona health
insurance companies had to provide guarantee issue to
children—no matter what their preconditions. However,
there was no mandate for mandatory insurance coverage.
From a financial standpoint, the carriers saw covering
all children, including those with expensive
preconditions, as a ruinous financial risk if the pool
of people to be covered was not expanded, so that
healthy children would help defray the cost of those
with precondition.
In response, the major carriers dropped all coverage for
children under 19.
What is a parent who wants coverage for his or her
children going to do? There are a couple of options.
He can add the child to an existing family policy, or
apply for a new family policy that will include the
under-19-year-old child.
He can apply to Arizona’s high risk pool. However, there
are a couple of requirements he needs to meet first The
child must formally be declined by an insurance
carrier—easy enough, if the child applies alone and is
under 19. But the child also must not have had insurance
for the prior six months. This is often a deal-breaker
for someone who is coming off a group coverage, for
example, and looking for coverage for his or her
children under the risk. No parent wants his child to go
without insurance for half a year.
Another option is to apply for temporary coverage. At
least one carrier is still writing this type of plan
that includes children only. Temporary insurance is
relatively cheap and usually is approved quickly. The
downside is that temporary coverage is exactly what it
says: after a maximum of six months, it’s over. You can
buy an additional six months worth of coverage, as long
as there has been no change in your child’s health
condition, but you can’t simply renew it. It is exactly
what it says: a temporary solution.
Some carriers are talking about offering child-only
policies during an open-enrollment period. In other
words, you would have a limited window each year to
apply. This would keep a consumer from waiting until
their child was sick before applying, and satisfy both
the needs of consumer to get coverage the carriers’ need
to limit their liability. .
Hopefully this will be solved in the future, but without
a mandatory requirement to have health insurance, the
insurance companies have no incentive in covering all
children, despite the guaranteed issue requirement. Keep
in mind that all of this is in a state of flux so the
rules may be different as early this afternoon. It’s
best to contact us as licensed Arizona health insurance
agents to go over your particular situation.
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