Missouri Health Insurance
Health insurance is one type of insurance you're pretty much guaranteed to use.
We all need medical attention from time to time, and some of us need it quite frequently.
When care is needed, you want to focus on getting better not on how you're going to come
up with the money to pay your medical bills. A good health insurance plan allows you to focus
on what's most important, your physical well being.
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Health Insurance who needs it?
Is there anyone who doesn't need health insurance? Not really. Even if you're young,
healthy and haven't had to see a doctor in years, you never know when you might be
involved in an accident or be diagnosed with a serious medical condition. While your
health insurance coverage will pay for things that aren't too costly like routine
doctor's visits or lab tests, the main reason to have coverage is to have protection
against the potentially catastrophic expenses of serious illness or injury.
Without health insurance you may be charged a higher price by the doctor or hospital
If you go to a doctor or hospital you may be charged a higher price if you don't have health insurance.
The reason for this is because the health insurance companies have contracts with doctors and
hospitals in their networks to only charge agreed upon amounts for each procedure. Each time
you use these doctors and hospitals you benefit from the lower negotiated rates.
Answers to Your Health Insurance Questions
Yes. Missouri is an open competition state and, as such, we do not have the authority
to regulate premiums on most types of health insurance. Our state relies on competition
among companies to determine the premium rates. Medicare supplement insurance premiums
are subject to some regulatory oversight.
Yes, the company has the right to deny coverage for almost any reason on a new application.
However, once you are accepted for coverage, your policy can only be terminated for one of
two reasons. The company can cancel your policy for failure to pay your premiums in a timely
manner. If you misrepresent information on the application or fail to disclose known
information, the company may rescind the policy for material misrepresentation.
This is normally a physical or mental condition for which medical advice, diagnosis;
care or treatment is recommended or received before the effective date of the policy.
The definition can vary from policy to policy.
HMO stands for Health Maintenance Organization, a managed care plan where you have the
ability to choose your primary care physician (PCP) from a list of network providers.
Your PCP is responsible for management of all aspects relating to your health care.
If you require care from any network provider other than your PCP, you may need a
referral from your PCP to see that provider. Check with your plan to see if your PCP
is also the "gatekeeper" for access to other network providers. You must obtain care
from a network provider in order to have your claim paid through the HMO. Treatment
received outside the network is generally not covered, or covered at a reduced level.
If your employer has more than 20 employees, it is subject to the federal Consolidated
Omnibus Budget Reconciliation Act (COBRA) law and entitled to a minimum of 18 months
of continuation coverage. Under each of these options, you will have to pay the full
premium yourself even if your employer paid part of your premium while you were employed.
You can find out more about COBRA continuation of group health benefits from the
Federal Department of Labor Office of Pension and
Welfare Benefits Administraton website or by calling 816-426-5131.
If your employer has less than 20 employees, you are entitled to 9 months of
continued group health coverage with your employers group plan under Missouri law
(376.428 RSMo).
Click here to get an instant health insurance quote.
Click here to get a customized health insurance quote.
Copyright © 2008 by The Insurance Resource