North Dakota Health Insurance and You
North Dakotans are expressing concerns about a growing number of qualities of their health insurance. Below are the answers to some of the most frequently asked questions (FAQs) about health insurance in North Dakota. The answers should help you, the consumer make informed and educated decisions when it comes to your health care benefits.
Currently, the North Dakota Health and Human Services is working to “establish a process for review of ‘unreasonable increases in premiums for health insurance coverage’.”
I have been turned down by health insurance companies in north Dakota. Where can I find health insurance?
The federal government, under the Patient Protection and Affordable Care Act must establish a temporary, high-risk pool of health insurance programs devoted to providing coverage for those without current health benefits.
The health insurance pool must must:
- Have no exclusions because of applicants’ pre-existing medical conditions
- Cover a minimum of 65% of a person’s total costs
- Have an out-of-pocket annual limit of $5,950 for individuals and $11,900 for families
- Have standard premiums established at a standard rate
Once the PPACA is in effect in all the states by 2014, this high-risk pool will phase out, and the North Dakota Health Exchange will take effect.
In addition, North Dakota has established the Comprehensive Health Association of North Dakota (http://www.chand.org/) (CHAND) for people who are unable to find health insurance elsewhere due to medical conditions, or they have lost their employer-sponsored health insurance.
If you are denied health insurance coverage in North Dakota, the insurance companies must inform you of CHAND by law. An individual is entitled to receive $1,000,000 in benefits in their lifetime. CHAND is administered by Blue Cross Blue Shield of North Dakota. By law, your premiums may not exceed 135% of the highest premiums charged by the top five largest insurers in North Dakota.
For eligibility for CHAND, one must:
- Be a resident of North Dakota
- Provide written evidence of rejection from other health insurance companies
I am pregnant and do not have maternity health benefits on my insurance policy. Will my baby get any coverage?
By law, all North Dakota health insurance companies must offer come kind of maternity benefits on every policy they sell. If you have not purchased maternity benefits, then you will not have coverage, nor will you be covered for the delivery of your baby.
NOTE: There are some statues that mandate maternity coverage for complications of pregnancy. Look for “complication of pregnancy” on your policy.
My health insurance premiums went up, but I haven’t made any claims.
The theory of health insurance involves a large pool of risk that is assumed by an insurance company, so that you do not have to worry about a large sum when you make a health claim. The claimant usually pays a small known sum for medical services, and their health insurance company pays the rest.
Health insurance companies that request rate increases for health insurance are required to submit a report to the North Dakota Insurance Department proving that the rate increase is not excessive, unfair or discriminatory.
Companies can revise their rates based on their experience insuring people in North Dakota, taking into account the premiums paid in and the claims paid out.
Your best bet is to shop around and get quotes from various sources. You can get quotes online, and one will usually provide an accurate assessment of how to lower your health insurance rates.
