Inclusive Health Update

On January 12, Michael Keough, the Executive Director of Inclusive Health, gave an annual update to the Joint Legislative Health Care Oversight Committee. Inclusive is North Carolina’s high risk insurance pool. To be eligible for coverage, the law states you meet one or more of the following:

1. have been denied coverage due to medical reasons, or offered
limited coverage on preexisting conditions.
2. can only receive coverage at a higher rate than Pool offers.
3. are receiving or eligible for HIPAA.
4. are diagnosed with a condition from a list on high-risk conditions.
5. are eligible for federal Health Coverage, for example, trade-displaced
workers.

Individuals with chronic illnesses, such as MS, often fall into one of the first two groups. The fourth point is important to note because it adds an element of convenience to the process and reduces unnecessary paperwork -- if you know you will be denied coverage, due to a preexisting condition or diagnosis, Inclusive Health won’t make you prove it.

Inclusive Health went into effect January 1, 2009, and has made considerable progress. Over the last year, 2,506 North Carolina residents have enrolled in the Pool. The denial rate is low, around 15%, and mostly due to applicants qualifying for other types of coverage. Enrollment, which is directly linked to income, is higher than expected in central and western counties. Marketing efforts are being looked at to find what ways can best reach the counties in eastern and southeastern North Carolina.

A recent and exciting development took place in November -- applications for a premium subsidy, Inclusive Health Assist, were accepted. The subsidy is funded by a federal grant and will provide discounts between 20-43% for and individual making 33K or a couple making 43K a year. More than 330 individuals have already accessed this assistance.

Continued health care reform discussions remain a topic of interest for Inclusive Health staff. For a comparison of how the US House and Senate have addressed high risk insurance pools, please visit here. To share your thoughts on high-risk insurance pools within the current health care bills, please leave a comment below.

Click here for more information on how Health Reform efforts are addressing Interim High-Risk Pools