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South Dakota Health Insurance

Health insurance now is available in two main categories in the form of individual insurance and group insurance. People who choose individual insurance are mainly self-employed, or are employed by a company that does not have a provision for a health plan, or who have a family and need individual insurance for their family members. If a person buys an individual plan, he/she has to pay an annual premium as well as a deductible for each insured dependent, up to a base amount. If the person goes for a group policy instead, he/she is needed to pay an annual premium, co-payments payable at each medical service, and a deductible payable before insurance begins paying for his/her legitimate medical bills.

Oregon allows health insurance companies to reject your application for individual insurance if you have a health problem. If someone is turned down, the Oregon Medical Insurance Pool is there to provide him/her with insurance. Insurers, however, are allowed to impose a waiting period of 90 days for coverage and a look-back period of six months to check for any pre-existing conditions. In Oregon, pregnancy can be considered a pre-existing condition, but not genetic information. If you have had coverage without any lapse of 63 days or more, you are entitled to get credit toward any exclusion periods. Your insurance cannot be cancelled in case you fall ill.

If you qualify, Oregon regulations say that cannot be denied or charged more for group health insurance coverage due to a medical condition. Your new employer may, however, seek a waiting period before offering group coverage and a new HMO may impose an affiliation period until coverage actually begins. If you have dependent coverage, you will have newborns and adopted children covered for their first 31 days. Group health insurers can review your medical records for the six months prior to coverage for pre-existing conditions. If one has maintained continuous coverage, with no lapse of more than 63 days, the person qualifies for a creditable coverage.

In Oregon small businesses having two to 50 employees cannot be refused small group health insurance or can have it cancelled on account of health issues within the employee group. The state laws require insurance companies to offer a standardized plan. If you have two to 25 employees, the cost of your premium will depend on modified community rating. If your staff strength exceeds 25, the premium can vary according to the health status of them. They can, however, get in touch with the Oregon Division of Insurance for regulations governing associations with group health insurance availability. Oregon does not allow self-employed individuals to buy group health insurance coverage.

Residents of Oregon can receive assistance from programs such as Medicaid, Breast and Cervical Cancer Program, Family Health Insurance Assistance Program, and Children’s Health Insurance Program.

As selection of the right quotes is really a difficult job, it is wise if you do a proper research before making a final decision. In any case, it is better to engage professional health insurance agents and brokers who can be of great help in this regard with their valuable experience and expertise.

The leading health insurance providers in Oregon include Assurant Health (formerly Fortis), Health Net, Kaiser Permanente, LifeWise Health Plan of Oregon, PacifiCare of Oregon, Regence BlueCross BlueShield of Oregon, and Security Life.

 

 

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Useful links and information:

http://www.state.sd.us/

Risk pool eligibility chart

 

 

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