Your Rights under Alabama Health Insurance Law
(Copyright 2005 All Rights Reserved)
Individual Health Insurance:
In Alabama, as in many other states, your health insurance options are somewhat dependent on your health status. Once you obtain health insurance, it cannot be canceled in the case that you become sick. Most health insurance is guaranteed renewable.
If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of the family. The Alabama Medicaid program offers free health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.
The ALL Kids health insurance program offers free or subsidized health coverage for children who do not qualify for Medicaid, are under the age of 19 and
have no health insurance. ALL Kids covers hospital and physician care, prescription drugs, immunization, and other services.
Under Alabama law, newborns are automatically covered under the parents’ fully insured health plan if the plan covers dependents. The insurer may require that the parent enroll the child within 31 days in order to continue coverage beyond the 31 days.
If you believe you may be at risk for cancer but are uninsured or underinsured, you may be eligible for free screening and treatment. The Alabama Breast and Cervical Cancer Treatment Program provides free cancer screening for qualified female residents. In order to be eligible, you must be an Alabama resident. You must also be aged 50 or older, at or below 200% of the federal poverty level, be uninsured or underinsured, and be ineligible for Medicaid or Medicare.
If you are HIPAA eligible, the Alabama Health Insurance Plan is your only guaranteed access to individual health insurance. However, if you are healthy, you may be able to buy individual health insurance from other insurance companies.
Individual health policies do not have to give credit for your prior coverage, unlike group health plans. Pregnancy may be considered a pre-existing condition in an individual health insurance policy.
If you move away from Alabama, you may not be able to buy individual health insurance in another state unless you are HIPAA eligible.
For more information on Alabama Individual Health Insurance, please visit Alabama Insurance Department at
http://www.seib.state.al.us/2k2/ahip/aa.asp
Group Health Insurance:
Discrimination due to health status is not permitted. The Acme Company offers two different health plans. Full time employees are offered a high option plan that covers prescription drugs; part time employees are offered a low option plan that does not. This is permitted under the law. By contrast, in a cost-cutting move, Acme restricts its high option plan to those employees who can pass a physical examination. This is not permitted under the law.
If you lose your group health insurance and meet other qualification, you will be HIPAA eligible. If so, you can buy an individual health insurance policy from the Alabama Health Insurance Plan.
If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. However, the insurance carrier can turn you down if your small business does not meet the participation or contribution requirements.
Group health plans cannot apply a pre-existing condition exclusion period for pregnancy, newborns, newly adopted children, children placed for adoption, or genetic information.
According to the latest list available from the federal government, the County of Mobile, the City of Mobile, and the University of South Alabama have decided that certain health insurance protections will not apply to their employees. If you have group health coverage through these employers, you should contact them for more information.
If you are HIPAA eligible, you can buy health insurance from AHIP. It’s covered benefits include hospitalization, physician services, prescription drugs, and some mental health and substance abuse services. Premiums vary depending on the coverage option you choose, your age and gender, and whether you smoke. In general, premiums will be no more than twice the amount that a healthy person would pay for a comparable private health insurance policy.
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