Islets of Hope assistance programs for persons with diabetes

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Important Disclaimer

We have provided this information for general information purposes only.  It is not intended to be a recommendation or endorsement of any program or entity.

As of July 2007, 34 states now offer state-run high-risk insurance pools:

Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Florida, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, West Virginia, Wyoming, Wisconsin

State-by-state listing of High-Risk Insurance Pools

 

To find out more about coverage available to you under HIPAA, see Georgetown University's “A Consumer Guide to Getting and Keeping Health Insurance” for your state.

Shernoff Bidart Darras & Echeverria is the nation's leading bad faith insurance law firm. They help insurers who have been illegally denied coverage for claims submitted.

 

 

Your Diabetes Community Site Index                                                                                
Financial & Assistance Programs for Persons with Diabetes

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Hock's offers 30-50% discounted prices on diabetes supplies.  We cannot specifically recommend or endorse any company but we have been listing Hock's in our resource directory for over a year as one of the two cheapest online companies to purchase from.  We recently affiliated with Hock's because our own experience with them has been so positive.  If you do place an order through our site, they will contribute financially towards our cause and you will get reasonable prices for diabetes supplies.

What is HIPAA?

The Health Insurance Portability and Accountability Act of 1996, more commonly referred to simply as "HIPAA" offers some protection for individuals who lose group health insurance coverage.  This most often happens when a person leaves a job or looses employment where they had been able to get a group health insurance policy.  These people may be “federally eligible individuals” or “HIPAA eligible individuals.” -- when they lose group health coverage.

Who is eligible for coverage under HIPAA?

To be HIPAA-eligible, you must meet all of the following criteria.

  • Have had 18 months of continuous creditable health insurance coverage, and

  • At least the last day of which was under a group health plan (including those offered by public employers, unions, and churches), and

  • Have used up any COBRA or state continuation coverage for which you were eligible, and

  • You may not be eligible for Medicare, Medicaid or a group health plan, and

  • You must not have health insurance (however, if you know your group coverage is about to end, you can apply for coverage for which you will be federally eligible), and

  • You must apply for health insurance for which you are federally eligible within 63 days of losing your prior coverage.


Tip:  If you are leaving a job where you have had group or other health insurance talk with your human resources representative before leaving to see if you are eligible for COBRA benefits.

HIPAA guarantees insurance offers that must cover diabetes

When a person is HIPAA-eligible the law provides that they are guaranteed an offer for insurance coverage under at least two health insurance policies to choose from that cannot exclude pre-existing conditions or make you wait for coverage.  Unfortunately, while medical conditions must be covered (including diabetes) insurance companies can charge whatever they want and HIPAA policies can be expensive.  An important consideration, however, is that high premiums to cover a chronic medical condition (and any future medical problems) are often far less expensive than having no coverage at all.

Some state programs require that you first exhaust HIPAA options before you can become eligible to apply to state-run high-risk medical insurance pools.

Individual states have different insurance coverage protection under HIPAA

Not all states address the requirements of HIPAA the same way.  For example, some states do not require private insurance companies that sell coverage to individuals to offer full insurance coverage under HIPAA.  In these states, private insurance companies can deny coverage or exclude medical conditions.  However, states that do not guarantee HIPAA protections from private insurance companies will offer HIPAA coverage through a state-run high-risk insurance pool.

While HIPAA itself does not limit how much an insurance company can charge for premiums many states do limit how much insurers can charge HIPAA-eligible individuals for coverage.  In some cases, these insurance pricing restrictions may also apply to other nonHIPAA-eligible residents.

 

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Page Updated  07/12//2007