Kansas Health Insurance Guide
Kansas Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
If you live in Kansas, you can choose from a variety of private health insurance plans that include plans for individuals and group plans provided by an employer, as well as Kansas State-funded affordable health insurance for eligible individuals and families, and federal programs such as Medicaid and COBRA.
Kansas is not a guarantee issue state. That means private insurance companies are not required to sell you an individual health insurance policy if do not meet their underwriting criteria. You can be turned down for any number of reasons including your past or current health. If you are accepted, the insurer has the right to impose an exclusionary period up to 24 months for any pre-existing conditions. Unlike many states Kansas has no mandate for a look-back period limiting the determination of a pre-existing condition. Kansas state law does not require an insurer to provide credit for prior coverage. It also allows elimination riders. Your premiums for an individual health plan in Kansas can be based on your age, sex, lifestyle habits and type of plan you choose. Kansas state law does place limits on how much an insurer can increase your premiums because of health issues.
Kansas is a guarantee issue state for group health plans issued to small businesses. If your Kansas health insurance is provided through your employer, your coverage cannot be denied because of your past or current health. However, a 3-month exclusionary period and 3-month look-back period for pre-existing conditions can be applied if you don’t have proof of creditable coverage. Furthermore, an employer can specify a waiting period before new hires become eligible for group coverage, although it must be applied equally and cannot be denied or changed because of your health status. Kansas allows group plan premiums to be underwritten based on the health status of employees within a group, but the rates cannot vary by plus or minus 25% of the indexed rate.
Kansas is a guaranteed renewal state. Regardless of your health, your insurer must renew your individual health insurance policy as long as you’ve paid your premiums on time and haven’t defrauded the company, or in the case of some HMOs, as long as you haven’t moved out of the service area. However, your premiums can be increased to reflect your current health status.
Kansas Mandated Health Benefits
Kansas laws require private health insurance policies to cover several state-mandated benefits. These currently include:
- Alcoholism and Drug Abuse Treatment
- Bone Mass Measurements
- Breast Reconstruction
- Dental Anesthesia
- Diabetes Supplies and Self Management
- Emergency Services
- Mammography
- Mastectomy and Mastectomy Stays
- Maternity and Maternity Stays
- General and Parity Mental Health
- Off-Label Drug Use
- Prostate Cancer Screening
- Well-Child Care
- Coverage for newborns under parent's policy
- Coverage for adopted children under parent's policy
- Coverage for continuation dependents under parent's policy
- Coverage continuation/employees
- Coverage for conversion to non-groups
Types Health Insurance Plans Available in Kansas
The following major medical health insurance plans are generally available in Kansas. Major medical plans cover illness and injury, hospitalization, prescription drugs and office visits, as well as the mandated services stated above.
Indemnity plans - Typically the most flexible and therefore highest priced choice, an indemnity plan lets you select your health providers and facilities. Depending on your plan, you will have to pay a deductible or co-insurance.
Preferred provider organization plans (PPOs) - You select from a network of preferred health care providers and facilities, and receive services at an agreed-upon discounted rate. You also have the option of going outside the network, but typically at a higher cost. You do not need a referral from a primary care physician to see a specialist. Premiums may be less than an indemnity plan but more than an HMO. You will have to pay a deductible or co-insurance.
Health maintenance organizations (HMOs) - HMOs plans require you to select a primary care physician from a prescribed network of providers, who must issue a referral before you can see a specialist. Services and covered costs are typically more comprehensive than those provided by a PPO. HMOs offer the advantage of affordable premiums and low out-of-pocket costs, with an emphasis on preventive care. Non-emergency services out of network are usually not reimbursed.
Point of Service plans (POS) - Similar to a PPO in that you will receive reimbursement for out-of-network care, but with an HMO’s requirement for a primary care physician who must provide referrals to specialists. Premiums, co-pays and co-insurance are typically higher than what you’d pay with an HMO.
Alternative Health Programs in Kansas
- Kansas Health Insurance Association
KHIA provides health insurance coverage to all eligible residents who cannot obtain health insurance from private health insurers, COBRA or Medicaid/Medicare; to residents who are eligible under the federal Health Coverage Tax Credit program; and HIPAA-eligible residents who have exhausted coverage options in the group market. KHIA plans are provided by one of two PPOs, depending on your location. You can choose from four different plans including one HSA-qualified plan. Deductibles and co-insurance vary per plan. Premiums are based on plan, sex, age and tobacco use but cannot exceed 125% of the standard risk rate for similar coverage available in Kansas. There is a 3-month exclusionary period to receive benefits for pre-existing conditions if there has been a lapse in coverage of more than 31 days before enrolling in KHIA. There is a lifetime maximum benefit of $2million. KHIA is open-enrollment.
Regulating Agency
The Kansas Office of Insurance is responsible for regulating Indiana’s health insurance industry.
Get access to Kansas health insurance quotes from
http://www.einsurance.com/health-insurance.
Kansas Insurance Department
420 SW 9th St
Topeka, KS 66612
(785) 296-3071 or (800) 432-2484 (in Kansas only)
http://wwww.ksinsurance.org/
Kansas Health Insurance Association (KHIA)
PO Box 1090
Great Bend, KS 67530
(800) 362-9290
http://www.khiastatepool.com
(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