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Indiana Health Insurance

Indiana health insurance is regulated by the Indiana Department of Insurance. The IDH mandates how insurance provides within the state will qualify clients, how the policies are designed and other issues. The department gives a lot of flexibility to carriers in creating guidelines about accepting applicants, however, newborns must be automatically eligible for coverage on their parents’ plan for the first 30 days following their births. In addition disabled children dependent on their parents for support and care are automatically eligible for coverage on their parents plans.

Each Indiana health insurance company sets its own boundaries about who to accept as clients. The law further states that an insurance company can refuse to cover any applicant for any reason as long as it is not a newborn or disabled child. Bias based on color, religious preference or nationality is also illegal.

Companies are not mandated by state law to provide health care policies that are standardize, however, there are certain tests and conditions that they are required to provide with each policy. Examples of these mandates include mammogram screenings as well as health care for diabetes.

Preexisting conditions can be excluded from health care policies for the first 12 months, but following the last day of the twelfth month, the condition is covered. The 12 month clock begins ticking at the time your policy is issued. Te definition of a preexisting condition in Indiana is any condition that you received diagnosis or treatment for within the 12 months before your current policy was issued. Insurance companies have the legal right in Indiana to search the prior 12 months of your medical records to see if there are preexisting conditions.

If they find a condition that was not disclosed on the application, they have the right to exclude it for a full 24 months from coverage. It is better to be transparent about any preexisting conditions and only face a 3 month exclusion than to not disclose it and have them find out on their own. Also, if you make a claim for medical treatment in the first 24 months of coverage, the insurance company has the legal right to go back two years before issuing the Indiana health insurance and check to see if it is a condition you actually already knew about or were advised of or treated for. If it is, the company can refuse to cover it now and can impose the 24 month exclusion rule.

Premiums are based on age, health and other factors. The companies have the right to set the rates where they want, but they cannot cancel you based on a claim. For example, if you are covered by the policy and have a medical event occur, your policy remains in effect. The state does allow the insurance company to raise your premium rate to compensate for the increased loss and future risk you now present to it.