Minnesota: Informative Content Related to
Individual Health Insurance Policies

(This content is provided as general overview only - not insurance law.)

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.  

Health Insurance made available to uninsurable residents of Minnesota

Minnesota Comprehensive Health Association - (MCHA) - This is a very uniquely structured program for the uninsurable residents of Minnesota as it is subsidized by the very same insurance companies that may decline you for individual health insurance coverage. It’s rates are 25% over standard rate for its product design adjusted annually.  (Writing Carrier: Medica)

Call and talk to one of our agents at Health of America Insurance Agency who will be happy to assist you in applying for coverage.

612-377-3222  or 1-800-868-2333