Understanding Individual Rhode Island Health Insurance Law

Rhode Island health insurance companies must adhere to several laws in order to remain in business in the state’s insurance community. All individual Rhode Island health insurance policies have what is known as guaranteed renew ability. This means that once an individual has a Rhode Island health insurance policy, he or she has the right to renew it at the end of each term regardless of increasing age or health status. When individuals apply for Rhode Island health insurance coverage, they can be denied a plan based on their age, health or other risk factors. However, there is an exception to this Rhode Island health insurance rule. If an individual has been continuously covered by Rhode Island health insurance for twelve months, any Rhode Island health insurance company to which he or she applies is required to issue an insurance policy regardless of any assessed risk factors.

Rhode Island health insurance companies are required to cover newborn and adopted children for the first thirty-one days. During this period, open enrollment period requirements are relaxed, allowing the parent to submit the paperwork needed to add dependent Rhode Island health insurance coverage to his or her plan without a late enrollment penalty. Disabled dependents can keep being covered on their parent’s Rhode Island health insurance policy past the age at which dependent coverage is usually terminated if the Rhode Island health insurance policyholder can provide proof that the dependent is not capable of supporting him or herself.

Rhode Island health insurance companies can impose elimination riders upon any Rhode Island health insurance policy. These elimination riders state that the Rhode Island health insurance company will not pay for specified or all pre-existing condition claims. Rhode Island health insurance companies can also issue exclusion periods instead of elimination riders. Exclusion periods are limited to twelve months under Rhode Island health insurance law. During this time, the Rhode Island health insurance company does not have to pay for claims relating to pre-existing conditions.

In Rhode Island health insurance law, a pre-existing condition is defined as any condition for which an individual received treatment or diagnosis within the last thirty-six months prior to initiated the new Rhode Island health insurance policy. Pregnancy can be included as a pre-existing condition for some Rhode Island health insurance companies.

Rhode Island health insurance companies have virtually no limits to how much they can charge for their Rhode Island health insurance premiums. They can base these premiums on information regarding the Rhode Island health insurance policyholder’s age, health, size of family and other risk factors used to determine the predicted cost to the Rhode Island health insurance company for insuring the individual. Because there is little regulation in Rhode Island health insurance law regarding premium caps or elimination riders, it can be hard to find a Rhode Island health insurance company that provides an affordable premium rate and also covers your pre-existing conditions. It is important to shop around and to explore all of your Rhode Island health insurance options before settling on one specific plan.

Understanding Individual Rhode Island Health Insurance Law

Insurance Resources

Insurance Articles