The insurance landscape in the U.S. is in a state of flux in the wake of the passage of the 2010 Patient Protection and Affordable Care Act. The provisions of the health care reform it designs will continue in stages through 2014 and beyond through a series of joint state and federal initiatives. Currently, states are administering high risk pools for individuals who have been excluded from health coverage on the basis of pre-existing conditions, and they are weighing the design of the health insurance exchanges that must, by law, go into effect by 2014.
Because of these changes, many aspects of state law will have to change over the next two years to comply with federal statutes. Keeping up with insurance regulations in your state, especially if you are a new resident, is vital to securing affordable, comprehensive medical care for yourself and your family. This is also true if you are one of the millions of Americans who needs assistance via one of the federal or state “safety net” programs like Medicare, Medicaid, and various programs to ensure children are receiving the health care they need.
Basic Insurance Regulations
Health insurance policies in Alaska cannot be canceled so long as the premiums are paid. Additionally, the policy language must include a provision of guaranteed renewability. Insurers are allowed to design the policy according to the company’s best interests, however, and they can eliminate riders.
Employers are not required to provide insurance coverage to part-time employees, but group insurance is to be made available for companies with 2-50 workers. Entities with more than 50 employees do not have to guarantee insurance coverage.
Creation of Health Care Exchanges and Temporary High Risk Pool
Although Alaska is one of several states suing the federal government for the overturn of the Affordable Care Act, the state is still moving forward to implement some aspects of the health care reform package. There has been no significant progress at this time toward the establishment of the required health care exchange, but residents can apply for coverage under the state’s Pre-Existing Condition Insurance Plan administered by the Alaska Comprehensive Health Insurance Association. Premiums range from $425 to $1,806 a month with a deductible of $1,500 and an out-of-pocket limit of $3,000.
Medicaid benefits and those provided through the Children’s CHIP-funded Medicaid Expansions are expressed as a percentage relative to the Federal Poverty Level. For infants under the age of one, the percentages are 150 and 175 respectively for each program. For children 6 to 19, the FPL levels are 150 and 175%.
Pregnant women can draw Medicaid benefit in the state at 175% FPL, parents at 80%, and the non-elderly disabled on Social Security at 80%.
In addition to standard federal Medicare benefits, there are 41 Medicare Prescription Drug Plans available in the state, 16 of which have $0 deductibles. The lowest monthly premium currently available is $23.80.