New Hampshire Health Insurance Guide
New Hampshire Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
As a resident of New Hampshire you can choose from a variety of private health insurance plans including plans for individuals and group plans provided by an employer. Depending on your income or employment status, you may also be eligible for New Hampshire State-funded affordable health insurance for individuals and families, and federal programs such as Medicaid and COBRA.
New Hampshire is not a guarantee issue state. By law, private insurance companies that sell individual policies must medically underwrite them and are required to sell you an individual health insurance policy if do not meet their criteria. You can be turned down for any number of reasons including your past or current health, gender, age and lifestyle habits. In New Hampshire, insurers are permitted a nine-month exclusionary period and a three-month look-back period for pre-existing conditions, but they must grant you credit for prior creditable coverage. New Hampshire also permits health insurance providers to issue Elimination Riders that exclude coverage for specific health conditions. Premiums can be based on your health, your age and history of tobacco use. The state does impose some rate restrictions on insurers in regard to what you can be charged for an individual health insurance policy. There are no requirements for insurers to issue standardized policies to individuals.
New Hampshire is a guarantee issue state for group health plans issued to small businesses, providing a minimum participation requirement is met. If your New Hampshire health insurance is provided through your employer, your coverage cannot be denied because of your past or current health. The insurer can impose a nine-month exclusionary period and a three-month look-back period for pre-existing medical conditions. Credit for prior creditable coverage is mandated if you have had no more than a 63-day break in your health insurance coverage. Your employer may impose a waiting period for eligibility for new hires, but it must be applied equally to all new hires. Premiums for small group health insurance may be determined by location, age and type of work and health status of the group with a permissible rate adjustment factor of 15%. If you are a self-employed group of one, you can qualify to purchase a group plan during either of two 30-day guarantee issue enrollment periods each year.
New Hampshire 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. Your policy can be canceled if your insurer discontinues a plan or no longer sells insurance in the state.
New Hampshire Mandated Health Benefits
New Hampshire laws require private health insurance policies to cover several state-mandated benefits. These currently include:
- Alcoholism and Drug Abuse Treatment
- Birthing Centers and Midwives
- Bone Marrow Transplants
- Breast Reconstruction
- Clinical Trials
- Contraceptives
- Dental Anesthesia
- Diabetes Supplies
- Early Intervention Services
- Emergency Services
- Hair Prostheses
- Mammography
- Maternity and Maternity Stays
- General and Parity Mental Health
- Off Label Drug Use
- Orthotics/Prosthetics
- PKU/Formula
- Coverage for newborns under parent's policy
- Coverage for adopted children under parent's policy
- Coverage for handicapped dependents under parent's policy
- Coverage for continuation/dependents under parent's policy
- Coverage for dependent students under their parent’s policy
- Coverage for continuation/employees
Types Health Insurance Plans Available in New Hampshire
The following major medical health insurance plans are generally available in New Hampshire. 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 priNew Hampshire 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 priNew Hampshire 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 priNew Hampshire 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 New Hampshire
The New Hampshire Health Plan
NHHP is the state-sponsored high-risk pool that offers health insurance to state residents who have been unable to secure coverage from private insurers because of a pre-existing condition or certain other qualifiers. NHHP also provides coverage if you are eligible because of specific Trade Adjustment Act or Pension Benefit Guaranty Corporation benefits. Other eligibility requirements may apply. You can choose from two Indemnity plans and four managed care plans. Deductibles, co-pays, coinsurance and maximum out-of-pocket expenses will vary based on the plan you choose.
NECHIP enrollment is open and coverage becomes effective on the first day of the month after your application is approved. Premiums depend on the plan selected but are are capped at between 125% and 150% of the average standard rate for similar coverage. There is a nine-month exclusionary period for pre-existing conditions, but proof of prior creditable cover must be deducted from the period.
New Hampshire Healthy Kids
NHHK provides free or affordable comprehensive health care for resident children under 19 whose families meet certain income levels and other requirements.
New Hampshire Kids Connection
This program provides free comprehensive health care for resident children up to age 19 who come from low-income families. Two programs, Healthy Kids Gold and Healthy Kids Silver, are offered and children are assigned depending on family income. Premiums depend on plan, ranging from free to $45 per child. Total premiums and co-pays cannot exceed 5% of total annual household income. There is a buy-in option of $198 per month per child if family income exceeds the cut-off level. Waiting periods may apply depending on plan, but waivers are available under certain circumstances. Enrollment requires review and renewal every 12 months.
Regulating Agency
The New Hampshire Insurance Department is responsible for regulating New Hampshire’s health insurance industry.
Get access to New Hampshire health insurance quotes from http://www.einsurance.com/health-insurance.
New Hampshire Insurance Department
21 South Fruit St, Ste 14
Concord, NH 03301
(603) 271-1406
http://www.nh.gov/insurance/
New Hampshire Health Plan
(877) 888-NHHP (6447)
http://www.nhhealthplan.org
New Hampshire Healthy Kids
1 Pillsbury St, Ste 300
Concord, NH 03301-3556
(603) 228-2925 or (877) 464-2447
http://www.nhhealthykids.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/