Kansas Health Insurance
Kansas Medical Insurance Overview
Options are available for people living in Kansas to enjoy insurance benefits through a variety of programs, including group health coverage, an individual policy or through the use of a state-funded program. Factors determining eligibility for these options vary, but are mostly dependent on income, gender and employment status.
Despite the fact that there are a lot of residents in Kansas who aren’t covered by insurance, the healthcare reform aims to assist them in providing a plethora of options. It endeavors to cover the entire population of the country as a whole, but will improve the lives of residents living in the state of Kansas. Below, we have provided a basic overview of the current healthcare climate in Kansas.
Kansas’ Health Care Issues
When compared to the other states with regard to the overall health of its inhabitants, Kansas is ranked in the 26th position. Below is a brief outline of the strengths and weaknesses of the state currently.
Strengths include few mental health days for residents, few days of poor physical health and a high percentage of young children who have received their immunizations. Weaknesses include a low rate of immunizations among the adolescent population, a low per capita public health funding and a high percentage of people who are obese.
Understanding Kansas’ Uninsured Population
Kansas is comprised of a population of 11% who are not covered under any sort of health insurance coverage as of 2014. The Kansas Health Institute has provided an article on the counties in the state that could use improvement when it comes to the health of the citizens residing there. The article reveals that Johnson County is the healthiest county in the state, leaving Wyandotte County as its least healthy.
A large problem in the state of Kansas is the amount of employers who offer group health insurance to their employees. Smaller companies with fewer than 50 employees are not likely to provide any sort of coverage to their workers as opposed to larger corporations operating in the state.
In the state of Kansas, 40% of small companies offer benefits, while nearly 97% of larger companies offer coverage.
Listed below are some facts regarding Kansas’ uninsured population, as presented by the Kaiser Family Foundation:
- Poor adults in the state who are earning 100% or less than the Federal Poverty Level (FPL) make up the highest percentage of uninsured residents in the state. Still, many residents who earn significantly higher incomes decide to forgo insurance coverage. Five percent of people earning 400% of the FPL are currently uninsured.
- 12% of poor kids living in Kansas are uninsured.
- 12% of lower income children in the state stem from families earning less than 200% of the FPL.
Group Health Plans
When you get hired into a company, your best bet for insurance coverage is to obtain it through a group plan from your place of employment. Fifty-two percent of people in the state of Kansas are covered in this manner. If you have a job, consult with your Human Resources representative to learn whether or not your workplace offers benefits to their employees. It is advantageous to obtain coverage through your job if it is offered because your employer will contribute a portion of the premiums each month. Depending on the level of coverage selected, you may end up paying a great deal for premiums every month, so it is best to research all of your options prior to enrollment.
The Department of Insurance regulates health insurance companies in the state of Kansas.
Prior to joining a group health plan through your workplace, look at all of the options presented to get a good idea of the coverage you may need in the future. Many companies have more than two options which offer varying levels of coverage to employees. In addition, you should ask when the open enrollment period is so that you can enroll at the right time. New employees are usually granted access to enrollment upon being hired into the company, but you should know this information in case you need to make changes or additions to your policy. Research each option with care so that you make the best decision available to you, but keep the following considerations in mind:
- Do you have to cover any dependents under your plan? Are you covering your spouse? Offer this information up early on in the process so that you can ensure your dependents receive coverage under your policy.
- Do you have any health conditions? If you do, you should check the plan to make sure that any conditions are covered so you don’t have to go without insurance coverage.
- Are you able to afford the health insurance premiums? Some group health options can be quite expensive, so you want to keep your budgetary constraints in mind when researching.
Pre-Existing Condition Exclusion Periods
A pre-existing condition is a condition from which you are suffering prior to your enrollment into any kind of insurance plan. Under HIPAA, if you have a pre-existing condition, you cannot be denied coverage under a contract through your employer’s group benefits. However, you may be forced to wait out an exclusion period if you have a pre-existing condition of any kind.
Exclusion periods are typically no longer than 12 months in Kansas before your benefits are active. Your insurance company can also look back into your medical records for a period of six months in order to make the determination as to whether or not you are suffering from a pre-existing condition. Dependents under the age of 19 are not subject to waiting out exclusion periods in the presence of pre-existing conditions, so when enrolling children, you won’t have to concern yourself with whether or not they can be treated under your insurance contract.
Affiliation or Waiting Periods
Affiliation periods apply to most people who enroll in group health insurance plans. This is a period of time in which you have to wait for your benefits to begin. In many cases, your affiliation period can be no longer than two months time. The exception is made for late enrollees who have to wait for three months.
Individual Health Plans
Six percent of Kansas residents are covered under individual insurance contracts. These plans are typically for people who are unemployed, self-employed or working for a company that does not offer health insurance coverage. There are little restrictions with individual policies because the insurance provider has the freedom to do a great deal of underwriting on the policy. Because of the little restrictions enforced on individual insurance providers, they can also reject your application if you have a pre-existing condition. With this plan type, all of the risk is centered on one person as opposed to group health benefits where the risk is spread out over a larger group of people. The Foundation for Health Coverage Education estimates that a healthy young person living in Kansas can obtain insurance coverage through an individual policy for a minimum of $60 per month.
If you lose your benefits status due to a loss of employment or change in marital status, you can apply for benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This temporary coverage can last up to 18 months and it usually picks up right where your previous insurance plan left off. You can be eligible for COBRA coverage depending on the size of the company with which the original benefits came. In Kansas, COBRA is available to former employees and dependents of companies that employed over 20 employees. After the exhaustion of COBRA, you can obtain continuation coverage under HIPAA. Another option is to obtain a conversion plan, which lets you continue your same plan type with the same insurance provider.
Kansas Health Benefit Exchange
In 2012, officials in Kansas announced that the benefits exchange would be managed on a federal level. The state put together several committees to explore the pros and cons associated with keeping the marketplace on a state or federal level. Afterward, it was decided that the marketplace would be run by the federal government. The state of Kansas received a federal grant, like other states, of $1 million for the creation and implementation of its health benefits marketplace. However, it also received another $31.5 million for financing the exchange’s technological methods.
Kansas State Insurance Programs
Kansas has many state-funded options for people who need to obtain health insurance benefits. These are public options and eligibility requirements are typically based on gender, age, income level and pre-existing conditions. The programs available are KHIA, PCIP, Medicaid, WIC, HealthWave, CYSHCN, Women’s Health Care & Family Planning Services, Early Detection Works, MediKan, Medicare, the VA medical benefits package, the Partnership for Prescription Assistance and the NAMI Helpline.
Below are detailed descriptions of each program:
Kansas Health Insurance Association (KHIA)
KHIA is a program that offers insurance benefits to those who have had trouble because of pre-existing health conditions. In order to receive coverage, you have to show proof of a pre-existing condition and premiums range between $166 and $2,082.
Pre-Existing Condition Insurance Plan (PCIP-KS)
Just like KHIA, the PCIP offers coverage to those who can prove that they have been turned down for insurance coverage. Benefits include hospital care, prescription drugs, primary and specialty care.
This program is offered to low income families and offers benefits that include prescription drugs, doctor’s visits, labs, immunizations for children and home health care. Income guidelines must be met to qualify for coverage under Medicaid. New enrollees may be able to get retroactive benefits from the three months prior to approval.
Women, Infants, and Children (WIC)
WIC offers beneficial food products to pregnant mothers, their infants or smaller children under five-years-old. The program also offers education on subjects related to breastfeeding and infant care.
This program offers affordable, low-cost health insurance for the uninsured children of Kansas along with some qualifying parents.
Children & Youth with Special Health Care Needs (CYSHCN)
For children with special needs, disabilities or chronic diseases, this program offers insurance coverage. Income level and qualifying medical condition are taken into consideration when approving applications for coverage under this program.
Women’s Health Care & Family Planning Services
This program offers a wide variety of services to women, including pregnancy testing, STD screenings, urinalysis and pap smears. Coverage is generally offered to a good portion of women living in Kansas without a lot of requirements.
Early Detection Works
Under the Early Detection Works program, woman can get mammograms, pap smears and diagnostic testing. To qualify, women must be between 40 and 64 years of age and certain income requirements apply.
Partnership for Prescription Assistance
The PPA is a free service that connects consumers with nearly 475 programs to obtain help with paying for prescription medications.
National Association of Mental Illness (NAMI) Helpline
The NAMI Helpline is a resource that staffs its call center with volunteers who are very knowledgeable about the issues faced by the mentally ill. The volunteers provide those who call in to the helpline with information, guidance and information on the available treatment options.
The Health Insurance Portability and Accountability Act (HIPAA)
HIPAA was enacted to create a level of protection for consumers with reference to their private medical data. Now, with the implementation of the Affordable Care Act, HIPAA has been expanded to include consumer protections against health insurance companies. HIPAA regulates COBRA coverage, affiliation periods, monthly premiums, exclusion periods and how those with pre-existing conditions are treated under the various program options. Consumers are also able to obtain continuation coverage after COBRA is exhausted under HIPAA. For more information on HIPAA and everything it contains, read the linked website.