Rhode Island Medical Insurance

Medical insurance is an important protection that no one should be without. It gives you security and peace of mind knowing that you have the resources to deal with serious injury or illness. If you are looking to buy medical insurance you will want to start first with an analysis of your family's needs in terms of healthcare and the amount you can afford to pay in premiums each month. Those who live in Rhode Island have an array of insurers to choose from who offer great policies to meet every need. The Rhode Island Department of Business Regulation is the regulatory body which oversees medical insurers and their offerings. More than 90% of Rhode Island's 1,000,000 plus residents have medical insurance.

Regulations For Individual Medical Insurance

Rhode Island is one of the 5 states that offer guarantee issue medical insurance coverage. In order to qualify an individual must have an unbroken prior coverage of 12 months. If you meet these qualifications, you must be offered a policy and cannot be declined because of your health status, nor can exclusions or changes be made to the policy. If you do not have the required previous coverage, your application will undergo medical underwriting. It can then be approved, denied or a policy offered with changes or exclusions added to it, based on the medical history. Insurers can go up to 3 years into the applicant's medical history for underwriting purposes. Exclusions for up to one year can be applied to such policies.

Medical Insurance for Small Groups

In Rhode Island, small groups are defined as employers with 50 or fewer employees. These groups must be given guarantee issue policies. This means that no group will be denied health insurance coverage, regardless of their overall health or medical history. Insurers can look at the previous 6 months of health history for underwriting purposes and may exclude certain things for up to 6 months. Some employees who qualify for coverage may have to wait before they are eligible to join the plan. The employer sets such waiting periods and they are uniform for all employees. Risk factors may cause premiums to be 10% higher or lower than the indexed rate for the insurance company.

Continuation Coverage and COBRA

The federal government has a plan called COBRA, which allows employees of certain size firms to continue their medical insurance coverage following termination for a period of up to 18 months. In certain situations, it may even be extended to 36 months. Rhode Island also offers a mini-COBRA law for smaller employers in the state. To meet the requirements to be eligible, the employee must be a member of a group that is too small for federal CODRA, and be laid off through no fault of their own. The mini-COBRA plan also allows continuation of your health insurance plan for 18 months or the length of time the employee was a member of the plan through his employer, whichever is shorter. Members have 30 days following termination to start mini-COBRA coverage continuation. The member must pay both the employee and the employer share of the premium. Conversion policies are often also available, but tend to be costly. Guarantee issue medical insurance is another excellent option if your coverage has been in place for more than 1 year