Alaska Health Insurance
Overview Of Medical Coverage In Alaska
Alaska’s distant locale and uncommon characteristics affect the available health insurance coverage in the state. There are very few commercial medical insurance companies in Alaska, meaning that the competition in the market is relatively low. The lack of competition means that it can be harder for Alaska residents to obtain acceptable health insurance from a private provider. Despite that, public health funding is high and recent changes in healthcare reform in the U.S. will likely improve the ability for people in Alaska to enjoy the many benefits that having health insurance provides.
Health Care Issues In Alaska
In comparison with the other 49 states in a ranking system created by The United Health Foundation, Alaska is ranked at the 28th spot. Various health issues that plague the residents of this state are violent crimes, occupational fatalities and binge drinking, but the state has a population of citizens that have active lifestyles along with enjoying the benefits of lowered levels of pollution in the air.
Understanding The Population Of Uninsured Residents In Alaska
Uninsured residents in the state of Alaska make up 18 percent of the population overall, and it makes Alaska’s proportion of individuals who are uninsured higher than the proportion of individuals in the country, which is 16 percent. About one fourth of the population of Alaska receives health insurance coverage through public programs, and another 52 percent receives coverage through an employer-sponsored plan. Healthcare spending in Alaska has seen a rapid increase in the recent past. In 2010, healthcare spending was at approximately $7.5 billion and has increased 40 percent over the previous five years. By 2020, spending on healthcare could top $14 billion, according to estimates. (Understanding Alaska)
Coupled with the higher costs associated with health care in the state of Alaska, the lack of much needed health care resources and expertise lead to obstacles posed to the uninsured population of Alaska.
Below, we have detailed some statistics with regard to uninsured residents in Alaska:
Alaska offers a High Risk Pool Program for those residents in the state who have pre-existing conditions. In 2011, enrollment was at 525 residents. For more than three quarters of the residents enrolled, the program requires a deductible amount of at least $2,500.
Medicaid covers sixty percent of children who live in poverty in Alaska, but 18 percent are still uninsured.
Individuals between 19 and 64 who are uninsured count for 23 percent of the population.
For more data on the various health insurance plans that are available to residents in Alaska, you can read through this matrix, which was created by The Foundation for Health Coverage Education.
Group Health Insurance Plans
A greater amount of the insured population in Alaska is covered under an employer-sponsored health insurance plan. When looking for insurance coverage, you should always check with your employer first in order to determine whether or not the company offers acceptable coverage. To enjoy all of the perks associated with employer-sponsored health coverage, you might be required to pay a premium monthly. Group health insurance plans are regulated by the Division of Insurance in the state of Alaska.
Signing Up For Coverage
There are specific periods in which you can enroll and sometimes you have to wait in order to join your employer-sponsored health plan. At many companies in Alaska, you can receive information about the details on health insurance enrollment directly from your human resources manager. Pay close attention to all of the information provided regarding your insurance options through your employer-sponsored program so that you can locate a policy that will take care of all of your medical needs and concerns while remaining cost effective for your budget.
Before signing up for group coverage through your employer, take the following information into consideration:
Can you save money by signing up through your spouse’s health insurance policy?
Do you need special health coverage because of a health problem that may not be available through your employer’s group plan?
Are the premiums paid monthly affordable? If not, does the state offer health coverage that you may be eligible for?
Alaska’s Division of Insurance has a website that contains a Consumer Guide for those considering purchasing health insurance coverage in the state. This guide can be consulted so that you can easily understand the various options available to you with reference to the group and individual health insurance plans in the state of Alaska.
Exclusion Periods For Pre-Existing Conditions
When you are looking for health coverage and you have a pre-existing condition, the ability for you to secure health insurance might be affected. According to the Consumer Guide by the Division of Insurance, people in Alaska with pre-existing conditions might be forced to wait nearly twelve months before they are able to use health coverage under a new policy. Despite those with pre-existing conditions being covered by group plans in Alaska, they might have trouble getting covered using an individual plan depending on the circumstances.
Private health insurance companies in Alaska can look back six months at most and the longest exclusionary period possible because of a pre-existing condition is twelve months.
Health Insurance Plans For Individuals
Statistics have revealed that 3 percent of residents of the state of Alaska receive coverage through an individual health insurance plan. The percentage is so low because it is more costly in comparison to obtaining group health insurance coverage or by receiving coverage under a government sponsored health plan. Individual health insurance coverage is harder to obtain because private insurance providers have a lot more freedom with regard to the underwriting process. This means that they can exclude people who have pre-existing conditions when they are offering individual health insurance plans.
In the state of Alaska, they do not impose any limits on look back periods or exclusion periods that private providers can demand of individuals seeking health insurance. Despite that, if you are denied individual and are unable to get coverage under a group plan, you may be eligible to receive coverage through Alaska’s Comprehensive Health Insurance Association Plan or by applying for coverage under the Pre-Existing Condition Insurance Plan.
For individual health insurance policies that cover dependents, those dependents will be covered automatically for the first 31 days that the policy goes into effect. Following that period of time, dependents must be enrolled for them to receive future coverage.
You may find yourself without health insurance coverage temporarily because of divorce, employment changes or losing dependent status. For individuals in any of these situations, the U.S. Department of Labor has developed the Consolidated Omnibus Budget Reconciliation Act (COBRA) to fill in any gaps that come up in health coverage. Eligibility for COBRA coverage depends on several factors, but your previous company’s size is an important factor. In companies with more than 20 employees, COBRA has made it a requirement that continued coverage benefits be offered to those who previously received coverage under a group health insurance plan.
Health Benefit Exchange In Alaska
Alaska has opted out of managing its own health benefit exchange and is thus managed on a federal level. Out of all of the states, Alaska was the only one that refused the exchange planning funds totaling $1 million from the government. Many residents show concerns for the expense factor involved in creating a unique health benefit exchange, while others bemoan the fact that the benefit exchange will not be custom designed with the best interests of residents of Alaska in mind, but rather something generic created by the federal government.
The health benefit exchange was up and running in the state of Alaska by 2014, which was a requirement. The exchange is meant to offer residents in every state in the country comprehensive health insurance that is affordable and subsidized by the government.
State Sponsored Health Insurance Programs In Alaska
There are plenty of options available for state-funded health insurance in Alaska, with eligibility dependent on age, wages, pre-existing conditions, ethnicity and employment status. Some available plans include the ACHA (Alaska Comprehensive Health Insurance Association) plan, the Pre-Existing Condition Insurance Plan (PCIP), Medicaid, Denali KidCare, Chronic & Acute Medical Assistance (CAMA), Indian Health Services, Medicare and the Medicare Prescription Drug Program, and the Health Tax Credit. Other available resources for Alaskans include the VA Medical Benefits Package, the Partnership for Prescription Assistance, the WIC (Women-Infants-Children) Program, the Anchorage Neighborhood Health Center (ANHC), the Anchorage Community Health Services and the National Association of Mental Illness Helpline (NAMI). The Foundation for Health Coverage Education gives a matrix out for all of the information provided on the various available health insurance plans in the state of Alaska.
Alaska Comprehensive Health Insurance Association (ACHIA) and the Pre-Existing Condition Insurance Plan (PCIP)
Under ACHIA, there are six different PPO plans that are provided to citizens living in Alaska or U.S. citizens in general. The ACHIA also has one program that isn’t related to a PPO that will remit 80 percent of the charges for health care services after a deductible amount of $1,000 annually is paid.
If an applicant for PCIP has gone without insurance for a six month period of time and can prove that they have been denied for insurance coverage because of pre-existing conditions, they are guaranteed coverage under PCIP. This coverage provides for doctor’s services, medications, and in-patient and outpatient hospital services.
If the family’s income is at or below 185 percent of the Federal Poverty Level, then the state offers Medicaid coverage to these Alaskan residents. Regulations are different for those applicants who are elderly, disabled or blind and these applicants can receive retroactive coverage for medical bills dating back three months before the application.
For those parents who can’t get coverage for their kids under a group or individual insurance package might be able to get coverage under Denali KidCare. Like other programs, this is also based on the Federal Poverty Level and pregnant females and children under 19 years of age can receive coverage under the terms of the plan.
Chronic & Acute Medical Assistance (CAMA)
For those adults living with chronic medical conditions, the CAMA program is available. To guarantee coverage under this plan, individuals can’t earn more than $300 monthly or $400 per month for couples. In addition to the income requirements, applicants can only have less than $500 to cover medical costs in order to be guaranteed coverage under CAMA. Health conditions covered under the plan include cancer that require chemotherapy treatment, chronic seizure disorder, chronic hypertension and chronic diabetes.
Indian Heath Services (IHS)
Individuals of Indian descent or a woman pregnant with the child of an eligible Alaska native might be able to receive health insurance coverage under IHS. Throughout the state of Alaska, there are several IHS-funded hospitals that are under the management of tribes and that provide medical help to IHS eligible participants. Those who participate in IHS are subject to paying little to no monthly health care charges.
Medicare and the Medicare Prescription Drug Program
Residents in Alaska can take part in Medicare and the Medicare Prescription Drug Program if they are senior citizens or are disabled. There are four parts to the Medicare program: Part A, which covers in-patient care services and rehabilitative services; Part B covers preventive medicine and outpatient care services; Part C handles the Medicare benefits through a private insurance company; Part D offers help with prescription drug coverage. Those residents aged 65 and older who have worked in a Medicare-covered workplace for ten years (or whose spouse has) are granted guaranteed coverage under Medicare, along with those suffering from a disability or renal disease.
Health Coverage Tax Credit
For those in receipt of Trade Adjustment Assistance (TAA), the option to acquire health insurance coverage through the Health Coverage Tax Credit is available. Those applying must be 55 or older and receiving pension benefits from the Pension Benefit Guaranty Corporation (PBGC).
VA Medical Benefits Package
All veterans regardless of the branch of the U.S. military served are typically eligible for medical benefits through the VA Medical Benefits Package. This program is comprehensive in coverage and has no monthly cost to veterans and also provides coverage for pre-existing conditions.
Partnership for Prescription Assistance
There are approximately 475 programs that make up the Partnership for Prescription Assistance. The included programs are both public and privately run and exist to help eligible people pay for the high costs associated with prescription medications. To find a program that you might qualify for, check the website for the Partnership for Prescription Assistance.
Women-Infant-Children Program (WIC)
WIC offers help in getting medical services like screenings and immunizations, healthy foods and educational resources to women who are considered low-income. This program helps out by giving coverage to these women and children so that their nutritional needs are met.
Anchorage Neighborhood Health Center (ANHC)
Since 1974, the ANHC has worked in the Anchorage community to eliminate the deficit in medical services overall. At its facility in midtown Anchorage, the ANHC offers the usage of consultation rooms, a dental clinic, x-ray services, lab services and a pharmacy.
Anchorage Community Health Services
For other health care necessities, citizens living in Anchorage can also discuss their options with Anchorage Community Health Services.
National Association of Mental Illness Helpline (NAMI)
Residents of Alaska suffering from mental illness can contact the NAMI helpline in order to obtain information on options for treatment along with resources dedicated to mental health. Volunteers familiar with the various health care solutions available in the country staff the helpline in order to provide the best assistance to those who need it.
Health Insurance Portability and Accountability Act (HIPAA)
The Department of Health and Social Services in the state of Alaska discusses the HIPAA and its effect on Alaskan residents on its website. In 1996, new HIPAA laws were enacted to impact the ability of insurance companies to refuse, lag or place limitations on health insurance to new plan members, especially with regard to those plans sponsored by employers. Those looking for health insurance coverage should familiarize themselves with HIPAA and the law’s effect on their rights to insurance through private insurance providers.