Alaska Health Insurance Guide
Alaska Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
Alaska residents can choose from several types of health insurance plans for individuals, group plans provided by an employer, income-based Alaska State-funded programs for eligible individuals and families, and federal programs including Medicaid and COBRA.
Alaska is not a guaranteed issue state. Private insurers issuing individual plans can turn you down because you’ve received medical diagnosis, advice or treatment for any condition. They also have the right to ask you to pay higher premiums and to offer you limited coverage because of a pre-existing health condition. Alaska law allows insurers to impose a 12-month exclusionary period for the pre-existing medical conditions, which includes pregnancy under many policies. When you renew your individual Alaska health insurance policy, the insurer has the right to increase your premiums based on your age, health and other factors. You are, however, guaranteed the right to renew your individual health policy and your insurer can’t deny or cancel your coverage if you become sick, as long as you pay your premiums and don’t commit fraud against the insurer. If your Alaska 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.
Alaska Mandated Health Benefits
Alaska law requires private health insurance policies to cover several state-mandated benefits. These include:
- Alcoholism
- Breast reconstruction
- Cervical cancer/HPV screening
- Colorectal cancer screening
- Contraceptives
- Dental anesthesia
- Diabetes self management
- Diabetic supplies
- Drug abuse treatment
- Mammography
- Maternity stays
- Newborn hearing screening
- Hearing aids for children
- PKU/formula
- Coverage for newborn under parent's policy
- Coverage for adopted children under the parent’s policy
Types of Health Insurance Plans Available in Alaska
The following major medical health insurance plans are generally available in Alaska. Major medical plans cover illness and injuries, hospitalization, prescription drugs and office visits, as well as the mandated services listed above.
Indemnity or Fee for Service Health Insurance
Typically the most flexible and therefore highest priced choice, an indemnity plan lets you select your health care providers and facilities. Depending on your plan, you will have to pay a deductible and/or co-payment.
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 Alaska
Health Savings Accounts (HSAs) – This is a less-costly option for many people. Such plans provide coverage for catastrophic illnesses and require that you open a health savings account to meet the deductible for each claim event. After the deductible is satisfied, the plan pays all additional costs incurred.
Alaska Comprehensive Health Insurance Association (ACHIA) – For Alaska residents who have been denied private health insurance because of a medical condition, the state offers ACHIA, a guaranteed issue of health insurance that offers qualified people the choice of six PPO plans and one traditional indemnity plan. Deductibles, out-of-pocket maximum costs and percentage of allowed charges paid by ACHIA vary per plan. All plans are capped at a maximum payable benefit of $2 million.
Denali Kid Care – This program is for resident children under 18 whose family incomes are between 151% and 175% of the federal poverty level and have no other health care insurance.
Chronic and Acute Medical Assistance (CAMA) – CAMA is for Alaskans ages 21 – 64 who have specific illnesses requiring medical care, but who don’t qualify for Medicaid, have little income and no health insurance coverage.
Regulatory Agencies
The Alaska Division of Insurance regulates the conditions under which the Alaska health insurers can sell private health care insurance to individuals and families.
Get access to Alaska health insurance quotes from einsurance.com.
Alaska Division of Insurance
9th Floor State Office Bldg.
333 Willoughby Avenue 99801
PO Box 110805
Juneau, Alaska 99811-0805
(907) 465-2515
http://www.commerce.state.ak.us/insurance/
(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/