Here’s insurance for those with existing conditions

High Risk Pool Plans Offer Coverage for Uninsured Ohioans

 Under federal health reform, those with specified pre-existing conditions must have access to health insurance, including inpatient hospital care, at a cost similar to what a healthy person would pay.

Qualifying pre-existing conditions include:

  • Chronic obstructive pulmonary disease
  • Chronic pain conditions
  • Coronary artery disease
  • Heart failure
  • Depression

A more extensive list of qualifying conditions is available at the Ohio High Risk Pool website. Another resource is www.healthcare.gov, which offers information on all 50 high-risk pool programs in the United States.

Ohio is one of 27 states choosing to run its own program; Medical Mutual is administering the federally subsidized plans available to Ohioans. For those who qualify, there will be:

  • No exclusions for pre-existing conditions
  • No waiting periods
  • No annual or lifetime limits
  • Caps on out-of-pocket expenses based on federal law.

Ohio High Risk Pool plans offer:

  • Office visit copays for routine visits
  • Inpatient and outpatient hospital care
  • Diagnostic tests
  • Access to Medical Mutual’s extensive SuperMed Network
  • Coverage for emergency medical services
  • Prescription drug benefits
  • Coverage for maternity services
  • Health and wellness programs

The links below offer more detail about Ohio’s options for $1,500 deductible and $2,500 deductible plans:

OHRP Coverage Highlights (1500 Plan)

OHRP Coverage Highlights (2500 Plan)

To qualify for the program, applicants must meet the eligibility requirements established by the U.S. Department of Health & Human Services and provide supporting documentation. Applicants must:

  • Be a citizen or national of the United States or lawfully present in the United States
  • Be an Ohio resident at the time of application
  • Be uninsured for six months prior to the application date
  • Have a qualifying pre-existing condition as evidenced by a denial of coverage by two insurers, or by documentation from a healthcare professional

For information, call 877.730.1117 (TTY: 800.982.8109) or visit OhioHighRiskPool.com for application information and eligibility requirements.

 

 

 

 

 

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Because healthcare information changes rapidly, you should always verify information with your providers.