Introduction: The health insurance condition in West Virginia does not significantly differ from the health insurance situation in rest of United States. In accordance to a survey conducted by The Center for Disease Control, almost 15% of the total West Virginia population did not get any coverage under West Virginia medical insurance plans per year, between 2001 and 2003.
In the below-mentioned abstract, we have talked about some important West Virginia medical insurance regulations as well as West Virginia medical insurance alternative options.
Regulations for West Virginia Medical Insurance Regulations
- All West Virginia residents having medical insurance under a group or employer policy can not be refused or restricted obtaining coverage under that group or employer medical insurance policy; based on health condition.
- West Virginia individuals looking for coverage under individual West Virginia medical insurance policy can be refused or restricted, depending on age, health or other criteria.
- All West Virginia medical insurance plans should have guaranteed provision for renewal. Guaranteed renewability provision lets a West Virginia individual renew his or her existing medical insurance plan. However, he or she should have disbursed all the premiums in time and provided no fake information, during the tenure of the policy.
- West Virginia medical insurance companies can impose both of elimination riders and pre-existing condition waiting periods.
- Elimination riders can keep away body systems, body parts or health conditions from coverage, even permanently, for the entire duration of the West Virginia medical insurance policy.
- As per West Virginia state health insurance law, a pre-exiting condition is an illness for which an individual has been treated, diagnosed or otherwise received medical advice within 2 year, prior to starting of new West Virginia health insurance policy.
- West Virginia medical insurance companies do not provide any coverage for any pre-existing condition during an exclusion period.
- Continual coverage from previous West Virginia medical insurance plan to new West Virginia medical insurance plan for pre-exiting condition waiting period is possible, if there was no breakage in coverage.
- As per state health law, West Virginia medical insurance companies can consider pregnancy to be a pre-exiting condition and so, they can impose a waiting period for pregnancy.
- All newborns as well as adopted children should be automatically covered under parent's medical insurance plans that cover dependants. However, they can remain under parent's plan for the initial 31 days of birth or adoption. The plans should be modified, accordingly, after that period.
- West Virginia medical insurance rates may differ on the basis of age health and other criteria and can be hiked accordingly depending on those risk factors.
- West Virginia medical insurance companies are allowed to refuse an applicant asking for coverage.
- West Virginia Health Maintenance Organizations or HMOs should offer coverage to any West Virginia individual during open enrollment period.
- West Virginia individuals between health insurance plans or jobs are able to apply for temporary West Virginia medical insurance policies offered by several medical insurance companies.
West Virginia Medical Insurance Alternative Options
Uninsurable West Virginia individuals and individuals facing difficulties obtaining West Virginia health insurance can apply for West Virginia medical insurance alternative programs.
- West Virginia Medicaid: The program is available to the West Virginia individuals who meet all the income as well as other qualifying criteria.
- West Virginia Small Business Plan: The program lets company-aided medical insurance much reasonable by merging West Virginia medical insurance organizations and West Virginia government organizations. Small business owner, who meets all the eligibility criteria, are able to apply for the plan.
- West Virginia Children's Health Insurance Program or CHIP: This program helps children and teens to get coverage; provided they should belong to the families, which are not qualified for West Virginia Medicaid or unable to afford the cost of West Virginia medical insurance.
- AccessWV: This the high risk pool for the state. It helps uninsurable West Virginia individuals obtaining West Virginia medical insurance. Pre-existing conditions may be applied.
West Virginia Insurance Commission
Post Office Box 50540
Charleston, West Virginia 25305-0540