Rhode Island Health Insurance

Rhode Island’s regulatory guidelines for health insurance companies are fairly different from what you will find elsewhere, so residents of this state should definitely have some idea of what they can expect before trying to purchase health coverage here.  The items below summarize the basic information you’ll need to get up to speed.

• Insurers in Rhode Island are required by law to include a guarantee of renewability in every health policy they sell.  This means that, provided you’ve been paying your premiums on time, you will be assured the option of renewing coverage as many times as you see fit.  In addition your health insurance cannot be cancelled on the grounds that your health has gotten worse.
• Insurance companies in this state are allowed to stipulate in any health plan they sell that certain pre-existing conditions will be excluded from coverage for up to three years.  Conditions that qualify for this exemption include any that were diagnosed or treated up to three years before the start of your new coverage.  The only way to prevent this is to make sure to maintain continuous coverage for twelve months before switching insurers— pre-existing conditions may not be made exempt from coverage in that case.
• Under most circumstances, insurers in Rhode Island are permitted to deny any application for coverage on the usual grounds: health status, age, and so on.  Those who have had continuous health coverage for twelve months before submitting their application, however, cannot be rejected on any grounds.  In either case, the pricing of health coverage will tend to be affected by risk factors, as is standard practice.
• Small businesses operating in Rhode Island with between 2 and 50 employees may not be turned down when applying for group health coverage, and they must be offered a plan with benefits comparable to what is already being provided to other small businesses in this state.
• Insurers of small businesses may require that certain conditions are met in order to keep the group policy in effect.  For example, there might be a minimum percentage of employees that must participate in the company plan or a mandatory employer contribution to each employee’s premiums.  Failing to fulfill these obligations can mean the cancellation of the entire company’s coverage, but at no point can an insurer cancel coverage on the grounds of illness among the insured employees.
• The cost of group coverage for small businesses in Rhode Island can vary based on the health status, age, family history, and demographics of the insured employees, but only within certain predefined limits.
• Group health coverage for lone self-employed entrepreneurs is available, but only through Blue Cross Blue Shield.  Individual health insurance is also available, and a large portion of the premiums for such coverage may be tax-deductible for a self-employed Rhode Island resident who chooses to itemize deductions.

Buying health insurance can be a complicated process for someone who isn’t prepared, and the best way to become prepared is to learn as much as possible about the kind of coverage you plan to get.  As long as you’ve got a clear idea of what you’re looking for and are willing to compare many competing offers, you stand an excellent chance of finding exactly the kind of health insurance you’re looking for.

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