State health insurance is a type of health insurance for people with chronic or pre-existing conditions who are at high risk. HIV, AIDS, kidney disease, obesity, and diabetes are the diseases that show up most often on this type of insurance. This high-risk pool is meant to be a safety net for these people by giving them some kind of insurance for a high price. Due to the cost, fewer people are taking part in this programme. This plan isn't good for people with low incomes. Rates can be up to twice as much as what health insurance usually costs on the market. The pool tends to have better benefits, but it is only for people who can really pay for insurance. So, most people who fit into this group and need this type of plan are probably not insured because they can't afford it. This plan is a last resort for people with illnesses that send them to the hospital or emergency room often, and it pays for itself quickly in that case. Some people who can't afford this are lucky enough to have a spouse who works and can add them to their policy through their employer. These plans can't be biassed against people with long-term or chronic illnesses. The State Health Insurance Pool knows that its rates are high, and it says that the costs of care for people who are always sick are also high. They need to charge more to get ahead and stay in business.
Most risk pools are run by the state and are not-for-profit groups. Most of the time, they don't use taxes to run their businesses. Most people who need this kind of service are either making up for what their regular plan doesn't cover or using it as a stopgap until they can find a plan that will take them at a lower price. People who want to get this kind of insurance must live in the state where they are applying. Before you can get residency status in most states, you have to live there for at least six months and in some up to a full year. You also need a document from another insurance company, which could be one of several. You will need proof that at least one company turned them down and didn't give them the benefits they asked for. You can also use proof of insurance that costs more. If you can show proof of insurance with a rider or rated policy, you may also be eligible. Any of these things could make it possible for you to join the risk pool in the state where you live. A reciprocity agreement is when a person who is eligible for the plan and is already on a similar plan, met the waiting period limit, and hasn't used up their lifetime maximum benefits can still be eligible if they move to another state after meeting the residency requirement. Not all states have this agreement in their plan, but most do.
Along with non-residents, there is a list of people who are not eligible for the high-risk pool. If you move to another state, you are no longer eligible. However, if your new state has a reciprocity agreement with your old state, you can become eligible in the state where you now live once residency has been established. Most people who are eligible for Medicaid or Medicare or who get those benefits are also not eligible. Many states do have a high-risk plan for people with Medicare, but you don't qualify if you get Medicaid or could get Medicaid. If someone dropped out of another plan and it's been less than 132 months, they can't join the pool until that time is up. People who have used up their plan's maximum lifetime benefits also don't qualify. Also, people who are locked up in a public facility can't join the risk pool. Other specific exclusions can be diseases or medical conditions that the state has decided they don't want to cover. There may also be a limit on how many people can be enrolled at once, so that only a certain number of people can be enrolled at any given time. All other qualified applicants will be put on a waiting list until a spot opens up. There seems to be a longer list of people who don't qualify for this high-risk benefit, which costs a lot of money anyway, than those who do.
