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Alabama Health Insurance

Overview Of Medical Coverage In Alabama

There are many health insurance choices for the residents of Alabama. Even though 14 percent of the state’s populace goes without insurance coverage, recent health reform mandates may cause a hike in the figures of citizens covered in Alabama. Health coverage choices in the state can range in the variation of public programs as well as private medical coverage which provide varying levels of coverage contingent on the individual’s needs and provider’s offerings. In the current political climate, health coverage has become quite the topic of debate, but the data offered below may change in the years ahead. Despite that, the information provide represents the status of the general health of residents along with the medical coverage offered in the state of Alabama today.

Issues With Alabama’s Health Care

Among the 50 states in the U.S., Alabama ranks at 45th in comparing the overall health of its citizens. Alabama’s ranking is somewhat low, but it has seen a great deal of improvement, moving up from the 48th place in the year 2011. Among the many health problems dealt with in the state of Alabama, the state has many adults who smoke, heart problems and a predominance of residents with sedentary lifestyles cited as culprits to the population’s health issues.

Uninsured Residents Of Alabama

Young adults from between the ages of 19 to 29 are the largest demographic of uninsured people in the state of Alabama. Studies have shown that there are roughly 50 percent of the state’s population that consists of individuals who are covered under employer-provided health insurance policies. Despite those figures, there are about 36 percent of smaller Alabama companies with fewer than fifty employees on their rosters that offer insurance coverage to their employees. Employees of these smaller companies that work on a part-time basis are usually not eligible for medical coverage. In general, a little over half of the companies in business in Alabama offer their employees some type of health coverage. Generally speaking, the percentage of residents in the state of Alabama who have no insurance coverage is less than the percentage of Americans who are uninsured.

The following statistics address the population of uninsured residents of the state of Alabama:

  • Alabama doesn’t extend COBRA program coverage to the employees of smaller companies like 40 other states.
  • For those deemed “uninsurable” by private insurance companies because of pre-existing conditions, there is a high risk pool program. This pool currently consists of 2,133 residents.
  • Alabama currently has 27 HMOs that consists of an enrollment of 215,580 residents.
  • Private health insurance companies are not required to include coverage for treatments dealing with infertility problems.

Group Health Insurance Plans

In the state of Alabama, the Department of Public Health and the Department of Insurance regulate private health insurance companies along with HMOs. Although there are rules in place that urge employers to give their employees various options for insurance coverage (like making the premiums paid by the employer tax deductible), it may still prove to be hard for these smaller companies to offer their employees coverage. Not only that, but it is sometimes too costly for the worker to enroll in the healthcare plan offered. Even though the employer’s healthcare plan is subsidized, monthly premiums are usually withheld from the employee’s earnings. Group insurance plans in the state of Alabama are regulated by the Health Insurance Portability and Accountability Act (HIPAA) on a federal level.

Getting Coverage Through Your Employer

As reported by the Department of Insurance, there are tax advantages to becoming part of your employer’s group health insurance plan. When you see insurance premiums deducted from your earnings, you are not required to pay tax on the income that was dedicated to those premiums. When making the decision of whether or not to contribute to the coverage offered by your employer’s health plan, you should keep this information in mind. It is key to remember that income not allocated toward the employer’s group health plan will be taxed accordingly.

When thinking about whether or not you wish to take part in your employer’s group health plan, you should keep the following information in mind:

  • There may be several options available to you among the choices offered through your employer. Employees can usually opt to pay lowered amounts for their premiums in order to receive a plan with less coverage. When considering your medical needs, you want to make sure you keep in mind that you may face health problems in the future. Waiving coverage options or taking a plan that isn’t comprehensive enough is simply gambling with your health.
  • You can cover your children under your health insurance plan until they reach the age of 26.
  • Those who are self-employed may be able to take advantage of group health plans under their spouse’s insurance plan or by applying to receive coverage through a professional or trade group.

It can prove to be quite hard to find a health insurance plan that offers coverage for people with pre-existing conditions in the state of Alabama. Policy provisions called elimination riders can permanently exclude people from receiving health coverage because of a pre-existing condition. These riders are permitted in Alabama and insurance providers can go back as long as 60 months into your medical history in order to determine whether or not they wish to extend coverage to you. Before receiving coverage under a new health insurance plan, applicants in Alabama may be required to wait through an exclusion period of up to 24 months.

Waiting Periods Or Affiliation

When enrolling in a group healthcare plan through your employer, you may have a waiting or affiliation period prior to your coverage going into effect. Exclusion periods due to pre-existing conditions will begin on the same day as your waiting period.

Individual Health Insurance Policies

Statistics have revealed that roughly 5 percent of residents in the state of Alabama are receiving insurance coverage through an individual medical plan. For those people who are self-employed or unemployed, this may be a necessity or the only option available to individuals whose employers don’t provide group coverage plans. At times, employees may choose to opt out of coverage offered by their employers in order to seek out other plans that offer more coverage for the employee’s spouse or family members.

There is a list of insurance providers on the Department of Insurance’s website for people seeking individual coverage in Alabama. Because the health insurance market is not well regulated in the state of Alabama, the possibility exists for insurance companies to do a large amount of underwriting so they can craft policies that benefit their own interests. Exclusions might apply to residents in Alabama who seek health insurance coverage through government sponsored plans.

For an individual health insurance policy for a healthy person who is 30 years old and a non-smoker, the average cost of the premium is usually around $150.

Eligibility for health insurance policies offered to residents in Alabama who can’t obtain coverage through their employer or an individual health insurance plan is determined by a variety of factors. These factors include age, health status, disability and income.

Health Benefit Exchange In Alabama

Alabama’s health insurance exchange is not state-based, but a federally managed exchange by default. The health insurance exchange in Alabama will be managed with the aid of a federal grant of $1 million to Alabama’s Department of Insurance. In 2014, the federal government took control of the health insurance exchange in the state.

At the time, there were concerns over the tax burden that the governor of Alabama thought might plague the state with the task of taking on a health benefit exchange run by the state. So, in order to combat this, Alabama’s legislators voted in favor of defaulting to a health benefit exchanged that is managed on a federal level. The health insurance exchanges in all of the states were completely functional as of 2014, with residents of every state being able to receive health insurance that is subsidized by the government.

Health Insurance Programs In Alabama That Are Sponsored By The State

Individuals who choose to seek health insurance coverage through the state will be able to select the program that is best designed to suit their needs. There are health insurance programs that are unique to the state of Alabama. These include ALL Kids, Pre-Existing Condition Insurance Plan (PCIP), the Alabama Health Insurance Plan (AHIP), Medicare, Medicaid, the VA Medical Benefits Package and the Alabama State Health Insurance Assistance Program (ASHIAP). You can see Alabama Health Coverage Matrix that is offered by Coverageforall.org for more information on the programs available in Alabama.

ALL Kids

The ALL Kids program is designed to offer inexpensive and comprehensive insurance coverage to children who are under the age of 19. The benefits provided under this plan include routine shots, checkups, doctor’s visits, dental care, substance abuse services, hospitalization and prescriptions. Blue Cross Blue Shield of Alabama works to collaborate with regard to the program.

In order to qualify for coverage under the ALL Kids program, children need to meet several guidelines. First, they must be citizens of the U.S. or eligible immigrants, they must not be eligible to receive Medicaid and they must not have any other medical coverage.

Pre-Existing Condition Insurance Plan (PCIP) and Alabama Health Insurance Plan (AHIP)

The PCIP makes it a requirement for insurance seekers to be uninsured for six months prior to completing the insurance application process. Individuals who are approved can show that they have been denied medical coverage on the basis of a pre-existing condition. There are a wide variety of benefits available under the PCIP and this program’s premiums can cost anywhere between $100 and $500 monthly.

AHIP has coverage options for indemnity plans and managed care plans, both of which can offer medical equipment, in and outpatient care, prescription medications, emergency and substance abuse care. In order to be eligible for coverage under AHIP, you must be a permanent resident of the state of Alabama and have insurance coverage through your employer that has run out. For the programs available, coverage can cost anywhere between $150 and $1170. These premiums are based on the applicant’s age, gender and their status as a smoker or non-smoker.

Alabama State Health Insurance Assistance Program (ASHIAP) and Medicare

There are several available programs for seniors and the disabled through Medicare in the state of Alabama. ASHIAP is a counseling service for Medicare which is offered to individuals in Alabama who want to receive Medicare coverage. There is guaranteed coverage available to citizens of the U.S. or permanent residents who are either older than 65 who have worked (or whose spouse has worked) in a Medicare covered occupation for at least ten years, or are of any age with a disability or the applicant has renal disease.

Medicaid

Individuals and families who have a low level of income might be able to get insurance coverage through Medicaid. Guaranteed eligibility for receiving Medicaid benefits is determined by income level with regard to the Federal Poverty Level (FPL) and can change depending on whether or not the applicant is pregnant, a child, parent, family, or a blind or disabled person. Those covered under Medicaid typically have to pay a co-payment for various medical services, including visits to the doctor’s office and prescription medications.

VA Medical Benefits Package

Veterans who have served active duty in any branch of the United States military can take advantage of insurance coverage under the VA Medical Benefits package. In addition to offering comprehensive primary and preventive care, this program also covers pre-existing health conditions.

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