HIGH RISK POOL |
HIPAA POOL |
Premiums are 10% higher than the average of the top 5 health insurance carriers in the state of Louisiana |
Premiums are 25% higher than the average of the top 5 health insurance carriers in the state of Louisiana |
Must be a resident of the state of Louisiana for at least 6 consecutive months |
Must be a resident of the state of Louisiana |
Cannot be eligible for, or receiving, other major medical health insurance coverage. This does NOT include hospital only, cancer policies or other limited benefit policies |
Cannot be eligible for, or receiving, other major medical health insurance coverage. This does NOT include hospital only, cancer policies or other limited benefit policies |
Must have a written denial of coverage from a health insurance carrier dated within one year of the time of application. |
Most recent coverage must have been under a group plan; or under an individual plan where the carrier has discontinued all health insurance coverage in the state of Louisiana |
Must apply within 63 days of the last day of coverage |
Must have a total of 18 months of “Creditable Coverage” |
Must elect and EXHAUST all COBRA or continuation benefits |
Most recent coverage must not have been terminated because of non-payment of premium, fraud or material misrepresentation |
Cannot be eligible for Medicaid, Medicare or group coverage (including COBRA) |
Cannot be eligible for Medicaid, Medicare or group coverage (including COBRA) |
Cannot be an inmate of a public institution |
Cannot be an inmate of a public institution |
Cannot have been terminated for non-payment of premiums with Louisiana Health Plan or have been paid the maximum benefits with Louisiana Health Plan |
Cannot have been terminated for non-payment of premiums with Louisiana Health Plan or have been paid the maximum benefits with Louisiana Health Plan |
NOTE: There is a 6-month waiting period in the High Risk Pool for pre-existing conditions |
NOTE: There is NO waiting period for pre-existing conditions |
Policy is effective on the first day of the month following the postmark date of the application |
If the application is postmarked prior to the ending of COBRA/continuation benefits, the LHP policy is effective the day after COBRA/continuation benefits end. If the policy is postmarked within 63 days after COBRA /continuation benefits end, the LHP policy will be effective on the postmark date of the application |
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You may additionally be eligible if you have been notified that you are Trade Adjusted Assistance Act (TAA) or Pension Benefit Guaranty Corporation (PBGC) eligible
There is NO pre-existing condition for children, spouse who are “Special Enrollees” that enroll within 63 days of birth, adoption or placement for adoption
There is a 12-month pre-existing condition for other “Special Enrollees” such as a spouse or dependent child of an Eligible Enrollee (Eligible Enrollees are enrolled, or eligible to be enrolled, in the HIPAA Plan.) |