West Virginia Health Insurance Regulations

In West Virginia health insurance companies are regulated to set standards for insurance coverage and to protect the rights of individuals and groups of individuals when buying and using their health insurance.

Like in most states, West Virginia health insurance policies are regulated in two main ways. Policies can be bought for individual West Virginia health insurance coverage and for insurance coverage of larger groups such as umbrella coverage for the employees of a business. In each instance there are laws and rights that West Virginia health insurance laws give to the buyer of the policy and to the provider of the policy.

For individuals, West Virginia health insurance laws dictate what health conditions are covered and how much an individual will have to pay for the West Virginia health insurance health coverage. Companies that sell West Virginia health insurance are given the right under state law to turn down individuals for reasons of health status or other health or health history factors that a West Virginia health insurance company would take into consideration when issuing policies. West Virginia health insurance companies are also allowed to limit your health coverage based on your health status or medical history.

Under West Virginia health insurance laws, HMO’s are required a period with an open enrollment period in which individuals can be accepted regardless of their health status. Also, West Virginia health insurance laws state that an individual cannot be turned down for health insurance if they meet the eligibility requirements set up by the federal government.

West Virginia health insurance policies set a few special provisions for individuals. Children born to or adopted by an individual are covered by the individual’s health insurance plan automatically for the first thirty-one days. Also, West Virginia health insurance laws state that a policy cannot be canceled by a West Virginia health insurance provider in the event that a policy hold gets sick. This rule is called guaranteed renewability and helps protect the West Virginia health insurance policyholder from companies that might decide not to pay for expensive health conditions. The law does not, however, limit the premium that a West Virginia health insurance company can require for expensive medical conditions.

Under group plans, West Virginia health insurance laws give special protections to those people under the policy. First, a West Virginia health insurance company cannot turn away anyone under the group policy due to health status or pre-existing conditions. West Virginia health insurance laws state that a pre-existing condition is a medical condition that has been diagnosed or treated recently and the law says that any such condition cannot be taken into account if it occurred within six months of receiving that particular West Virginia health insurance plan. If you change your coverage or switch to another group plan, West Virginia health insurance laws prohibit the use of pre-existing conditions in deciding your coverage if you have had continuous health insurance coverage in the past.

For certain low-income workers, West Virginia health insurance programs are available cheaply through Medicaid. Children of low-income families can also get free or cheap insurance coverage through West Virginia Children’s Health Insurance Program. One should always consult their local assistance programs for help in acquiring West Virginia health insurance.

West Virginia Health Insurance Regulations

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