Alabama Health Insurance Guide
Alabama Health Insurance
Alabama Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
As an Alabama resident you can choose from a variety of health insurance programs including plans for individuals and group plans provided by private insurance carriers, as well as Alabama State-funded low-cost and no-cost health insurance for eligible individuals and families, and federal programs such as Medicaid and COBRA.
Alabama is not a guaranteed issue state. Private insurers are not required to sell health insurance to individuals who do not meet their underwriting criteria. You may be turned down, asked to pay higher premiums or offered limited coverage because of pre-existing health conditions. When you renew your individual policy, the insurer has the right to increase your premiums based on age or other factors. Alabama is a guaranteed renewal state; while your insurance company has the right to increase the premiums on your individual health care policy based on age or other factors, they cannot cancel your policy as long as you pay your premiums, don’t defraud the insurer and, in the case of some managed health programs, don’t move out of the coverage area. If your Alabama health insurance is provided through your employer’s group plan, your coverage cannot be denied, limited or subject to higher premiums because of your health.
Alabama Mandated Health Benefits
Alabama laws require private health insurance policies to cover several state-mandated benefits. These include:
- Alcoholism
- Breast reconstruction
- Colorectal
- Prostate cancer screening
- Drug abuse treatment
- Mammography
- Maternity stay
- General mental health
- Off-label drug use
- Coverage for newborns under the parent’s policy.
Types of Health Insurance Plans Available in Alabama
The following major medical health insurance plans are generally available in Alabama. Major medical plans cover illness and injuries, hospitalization, prescription drugs and office visits, as well as the mandated services stated above.
Health Maintenance Organizations (HMOs)
HMO plans require you to select a primary care physician (PCP) from a prescribed network of providers. You cannot see a specialist without a referral from your PCP. Comprehensive health care services include preventive care, medical treatments and hospitalization. There is no deductible, but there are co-pays when services are rendered and for any prescriptions. HMOs offer the advantage of relatively affordable premiums and low out-of-pocket costs as long as you stay within the network. Non-emergency services out of network are usually not reimbursed.
Preferred Provider Organizations (PPOs)
Like HMOs, there is a network of preferred providers in a PPO, but you can opt to see a provider outside the network if you don’t mind paying higher co-pays. Unlike HMOs, you need not select a PPC or secure a referral to see a specialist. PPOs typically have deductibles you must satisfy, as well as higher co-pays. The trade-off is greater freedom of choice in providers and services.
Point-of-Service Plans (POS)
A POS plan is a hybrid of HMOs and PPOs; you get the lowers costs of the former and the freedom of choice of the latter. You are required to select a PPC, but he or she can refer you to specialists in and out of network. Medical care provided out of network involves a deductible and either a percentage of the costs not covered by the POS, or the difference between what the provider charges and what your POS considers reasonable and customary for the service. There is no deductible for in-network services, but there is a small co-pay.
Alternative Health Programs in Alabama
High-Deductible Health Plans (HDHPs) - A less-expensive option for many people, HDHPs provide coverage for catastrophic illness and require that you open a health savings account (HSA) to meet the deductible for each claim event. After the deductible is satisfied, the plan pays all additional costs incurred.
Alabama Health Insurance Plan (AHIP) – If you lose your employer-provided health plan and meet other eligibility requirements, you can buy an individual health insurance policy from AHIP. Policy charges are capped and there is no new pre-existing condition exclusion period. AHIP policies are renewable as long as you pay your premiums, live in Alabama and meet other requirements.
Alabama ALL KIDS – You may be eligible to buy health insurance for your children who are 18 or younger and meet other eligibility requirements through this Alabama State-sponsored children’s health insurance plan.
Alabama Breast and Cervical Cancer Treatment Program – This provides free screening and treatment to qualified uninsured and under-insured female residents, who may also qualify for medical care through Alabama’s Medicaid Program.
Regulating Agencies
Contact the Alabama Department of Public Health and the Alabama Health Insurance Department for issues concerning health insurance information in Alabama.
Get access to Alabama health insurance quotes from http://www.einsurance.com/health-insurance/.
Alabama Department of Insurance
PO Box 303351
Montgomery, AL 36130-3351
http://www.aldoi.gov/
http://healthinsurance.alabama.gov/
(334) 269-3550
AHIP
(334) 263-8311
http://www.alseib.org/Healthinsurance/ahip/
(NAIC) National Association of Insurance Commissioners
The National Association of Insurance Commissioners (NAIC) is the organization of insurance regulators from the 50 states, the District of Columbia and the five U.S. territories. The NAIC provides a forum for the development of uniform policy when uniformity is appropriate. NAIC members are the elected or appointed state government officials who along with their departments and staff regulate the conduct of insurance companies and agents in their respective state or territory.
http://www.naic.org/
Insurance Information Institute (I.I.I)
The mission of the Insurance Information Institute (I.I.I.) is to improve public understanding of insurance -- what it does and how it works.
Contact info:
110 William Street
New York, NY 10038
212-346-5500
http://www.iii.org/