WHERE IS THE REFEREE?
What Are the Insurance Company Rules in Your State?
Oversight of the health insurance industry is supposed to be the job of state officials.
In most states, the rules favor the industry. They can reject your application because you need health care. They can set their own rates and charge lots more money because you’re older or a woman. And they can deny claims or drop enrollees based on preexisting conditions or other trap-door clauses in your policy.
- In 36 states, insurance companies can reject your application for coverage because of your health, age or just being female.
- If you are denied coverage because of your health, 16 states have no high-risk pool to help you get health insurance.
- If you are turned down by all insurance companies and cannot buy health insurance, 44 states have no insurer of last resort.
Plus, in many states, regulators are asleep at the wheel, have their hands tied by state law, or are too busy palling around with the industry. California regulators are actually too afraid to try to collect a $1 million fine against an insurer!
It is important for you to know what your rights and protections are in your state and to complain to your state department of insurance if those rights are being violated.
How does your state stack up? We have outlined important rights and protections in the individual health insurance market by state.
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In addition, these sites can help you learn about your other rights and protections:
LATEST SCORECARD
Fifty-eight percent of primary care doctors in the U.S. report their patients often have difficulty paying for medications and care, and half of U.S. doctors spend substantial time dealing with restrictions insurance companies place on their patients’ care, according to the 2009 Commonwealth Fund International Health Policy Survey.
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Families saw their premiums for job-based health insurance rise to an average of $13,375 annually in 2009, with workers paying an average share of $3,515 and employers paying $9,860.
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