Insurance mandates unique to Minnesota (applies to all individual health insurance policies).
Child Health Supervision Services - Benefits include pediatric preventative services, appropriate
immunizations, development assessments and laboratory services
appropriate from the moment of birth to age 6. Covered visits are as
follows: (1) birth to 12 months - 5 visits: (2) 12 - 24 months - 3
visits: and (3) 24 - 72 months - an annual visit. The
medical deductible is waived and covered charges are paid at 100%.
(source - Fortis Insurance Company, form 27114)
Prenatal Care
- Benefits are a comprehensive package of medical and psychosocial
support provided to a female covered throughout pregnancy, including
risk assessment, serial surveillance, prenatal education, and the use of
specialized skills and technology when needed. Benefits not included are
expenses incurred for labor, delivery, observation of the mother and
infant and postpartum care. The
medical deductible and coinsurance are waived.
(source
- Fortis Insurance Company, form 27114)
There are many different types of individual plans to choose from.
(1)
Major
medical - typically a deductible and coinsurance type plan in
exchange for reduce premiums.
(2)
Preferred
Provider Organization Plans
(PPO’s) - offering premium savings for agreeing to use a specific
network of providers who have pre-agreed to a pricing schedule for their
services. Many PPO products are a major medical type product with the
enhancement of copays for doctor visits and copays for prescription
drugs, etc.
(3)
Health
Maintenance Organization (HMO)
- not a fee for service type of coverage.
In general, hmo’s collect premium and disperse the premium to
its provider members monthly whether or not you visit a provider as a
patient. This is the reason that
hmo’s often keep you assigned to a specified provider or
provider facility.
(4)
Health
Savings Account (HSA’s)
- a two product concept
that combines a high deductible major medical type of plan at reduced
costs and a tax deductible account (similar to an IRA).
The
insured / account holder may contribute dollars to his tax deductible
HSA account and withdraw from it to pay eligible medical expenses
without penalty. What makes the HSA a great product is: (1) the list of
eligible expenses allowed for withdrawal of funds, far exceed the
covered items of most insurance plans. An example: eyeglasses, contact
lenses, dental treatment, braces, dentures,
birth control pills, vitamins (if prescribed), hearing aides and
the list goes on and on (with pretax dollars!!! - are you seeing the
value here???). (2) You own your HSA account - at age 65, your Health Savings Account has
the potential to provide a healthy retirement supplement.
When a resident of the state of MN makes application for an individual health insurance policy:
The
insurer may issue the
policy: (1) standard as applied for, (2) issue with a rate-up of
premium, or (3) decline a person for coverage, based upon prior medical
history.
