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Utah Risk Pool : Health Insurance Provided for the Uninsurable

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FAQ

Acronym or name of the risk pool: Utah comprehensive health insurance pool or HIPUTAH.

Regulation establishing risk pool: Utah state legislature in 1990.

Funding: The programme receives funds from premium payments by members. Funds are also received from state funds like Utah Comprehensive Health Insurance Pool Enterprise Fund.

Plans offered: A medical insurance plan is offered through the HIP Utah programme. It is a PPO plan with 2 different variables.

Plan benefits: The risk pool offers a plan with 2 different deductibles of $500 or $1000. It applies to covered medical services within the network only. For out of network services, the member is expected to pay 20% as coinsurance. The out of pocket maximum limit is $1500 on the $500 deductible plan. It is $2000 on the $1000 deductible plan.

Maximum benefit limits: The maximum benefits to be provided are $200000 in a year. The lifetime benefit is $1000000.

Eligibility: (1) The person under 65 and a resident of Utah for 12 months before the date of submission of application. This is not applicable if you had a previous cover under a separate state risk pool or you were receiving covers under HIPAA. (2) You should provide proof of the fact that you had suitable covers for at least 18 months before your application. (3) The gap in insurance cover should not have been more than 63 days. (4) The person should have been without health cover for at least a period of six months prior to applying for covers. (5) You may not be eligible for any other cover. (6) You must not be a resident of a mental institution. You can provide proof of any one of the following: (a) You have received a notice rejecting your application for insurance because of medical reasons. (b) You were not able to obtain insurance because of a pre existing medical clause.

Enrollment periods: One the person has been approved for coverage under HIPUTAH, he must meet a representative within 90 days and complete interviews before covers become effective. This is not required if the person qualifies under HIPAA.

Premium payments: Your age, gender, tobacco usage and plan selection determines the premium you pay.

Premium calculations: Contact HIPUTAH for details.

Pre existing condition waiting period: Is provided for a person with a pre existing condition. It is waived for a person with HIPAA coverage that was not ended earlier than 63 days prior to the application.

Contact information: HIP Utah. C/O Regence Blue Cross Blue Shield of Utah .2890 East Cottonwood Parkway. PO Box: 27797. Salt Lake City. UT- 841270797. Ph-18004622767. HIPUTAH Website.

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