Montana Medical Insurance Plan Policies

Everyone wishes for good health, especially when it comes to his or her loved ones. But as they say, accidents happen and it is beyond our control if a family member gets sick. Medical insurance plays a big role when it comes to maintaining your family's wellness. When the hospital bills start coming in, you'll be glad you're insured. In order to choose the best medical insurance plan, you must do some research first, online or with a local agent. It's important that the plan you choose matches your family's needs and that you can afford it.

If you are an individual living in Montana, it's good to know that you have many maedical insurance companies and plans to choose from. The regulations of health insurers to sell private health insurance to individuals and families are governed by the Montana State Auditor's Office.

Insurance companies within the state are permitted to have each application medically underwritten. This simply means that every medical insurance company has the right to either approve or decline an application. This would be based on the health condition of the applicant. An elimination rider may be included in the policy of an individual who has a pre-existing condition. This limits or confines the benefits for the treatment of the medical condition. Montana requires every insurance company to put forward a standardized health plan. This will include a 50% coinsurance, a $5,000 payment, and an annual fee of $1,000.

However, every insurance carrier is permitted to offer other non-standardized medical plans, according to their own profit levels. There are no premium caps imposed to insurance carriers that offer individual medical plans. There may be a higher fee depending on any existing health conditions and further demographic features. There is a maximum of 36 months as a look-back period and 12-month existing condition exclusionary period. Eligible coverage is acknowledged and applied to this exclusionary period.

A small business or company in Montana is composed of 2-50 employees. When a small group decides to have small business health plans or insurance, the insurers may not reject the application as long as the group is qualified for it. The premium fee of newly applied small groups may range from 25% depending on the every member's overall health condition. Some employees are asked to wait for new hires to arrive before applying for a group plan. But they must do so within 30 days after the new hires have joined in. A 2-month waiting period is required by HMO carriers on any new hire who signs up in the HMO plan. Newborns and newly adopted children can be added to the plan within one month of final adoption or the newborn's birthday, but not during the enrollment period.

Insurance companies rule out management or treatments of pre-existing medical conditions after 6 months of medical history assessment. However, they must have prior coverage that is creditable and then have that deducted from the exclusion period time. Minimum requirements should be met by every small business that wants to have group health insurance.

An employee who decides to leave must still be given coverage under the group health plan for 18 months. This is mentioned in the Federal COBRA regulations. The employee should meet COBRA eligibility requirement and must be working for a company with 20 or more workers. The dependents of the employee still stay on COBRA as well and this is for 36 months.

On the other hand, to those companies with less than 20 employees, a mini-COBRA law is applied. Unfortunately, this is not offered in Montana. A group plan that is not qualified for COBRA may be converted if the group where the individual came from has been on the plan for at least 3 months. A conversion plan switches the person's group coverage into an individual medical plan with a premium not more than 150% of the standard fee. To those who have maxed out their COBRA benefits or are not eligible for medical reasons, there is still the Montana Comprehensive Health Association. It is the state's high-risk pool and extends guarantee issue health insurance but with a more expensive monthly premium.

Summary: Montana residents have a wide array of medical insurance plans that they can choose from. These companies are allowed in this state to underwrite every application for medical health insurance .