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New Hampshire Health Insurance

Health insurance is an indispensable alternative that we cannot do without. Even though, buying suitable health insurance coverage for your family is expensive, it needs a comprehensive evaluation of all future risks and its effect on your finances. More than 47 million Americans are uninsured, majority of whom are the working families. These families often expose themselves to the crushing medical expenses of the lack of proper health coverage. However, for those families who are not covered under their employers’ group plan, there are low-cost state sponsored health insurance programs.

According to the America's 2008 Health Rankings, New Hampshire is the 3rd healthiest state to live in and obtain better healthcare services. The state continues to maintain its place in the top five healthiest states list; the state was at 4th and 3rd spot in 2007 and 2006 respectively. The moderate prevalence of binge drinking, moderate public health funding, decline in the prevalence of smoking and the decrease in the percentage of children under 18 in poverty have led to a robust health care system in the state. New Hampshire, having the population of more than one million citizens, boasts of both private-market and public health insurance alternatives. The private-market health insurance comprises of numerous types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide low-priced health coverage to the uninsurable residents of New Hampshire who meet specific eligibility requirements.

The New Hampshire Insurance Department is in charge for regulating all types of insurance sold in the state of New Hampshire including health insurance policies offered by private-market health insurers or public health coverage programs. However, despite all positive health features of the state, approximately 11% of the population remains uninsured. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, approximately 48.5% uninsured New Hampshire residents come under the above 200% FPL category.

Choosing a health plan is not as simple as it was before. Before buying a particular health policy, consult with a licensed health insurance agent/broker to avail the appropriate health insurance alternatives.

Individual/Family Health Insurance

Below is the guidelines for applying for and obtaining individual health insurance in the state of New Hampshire. These regulations apply to all insurance companies offering individual or family health insurance in New Hampshire:

Medical Underwriting

Yes

Pre-Existing Condition Exclusion Period

9 months

Look Back Period

6 months

Look Back Standard

Objective

Mandatory Benefits

Cancer screening for women including breast cancer screening, reconstructive surgery after mastectomy, direct access to OB/GYNs, eating disorder parity, maternity care

Market Rate Restrictions

Yes

Guaranteed Issue Options

None

Small Group Health Insurance

Below is the guidelines for small group health insurance in the state of New Hampshire. These regulations apply to all insurance companies offering small group health insurance in New Hampshire:

Small Group Size

1-50

Employee Qualifications

Two employees must be present for half of the preceding calendar quarter and
work 20 hrs/week

Guaranteed Issue

Yes

Premium Rating Factors

Adjusted Community Rating

Rate Adjustment Factors

Modified Community Rate

Look-Back Period

3 months

Pre-existing condition exclusionary period

9 months

Mandatory Benefits

Same as individual

State Cobra Variations for Small Groups

Below are the COBRA guidelines for small groups in the state of New Hampshire. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:

Mini-Cobra Option

Yes

Eligible Group Sizes

2-19

Extension of Benefits Period - Standard

18 months

Extension of Benefits Period - Disabled

18 months

Maximum Premium Increase

102%

State Legislation Reference

CHAPTER 415 ACCIDENT AND HEALTH INSURANCE, Section 415:18

Additional Notes

Certain qualified individuals may qualify for an additional 18 months of coverage.

State Sponsored Health Insurance Programs

There are several state sponsored health insurance programs in the State of New Hampshire to assist those without insurance in obtaining adequate coverage.

High-Risk Pools

Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of New Hampshire is summarized in the chart below:

Plan Name

New Hampshire Health Plan (NHHP)

Website

http://www.nhhealthplan.org/

Phone Number

877-888-NHHP (6447)

HIPPA Eligibility Required?

Yes

Available Carriers

Benefit Management Inc.

Pre-Existing Condition Waiting Period

9 months

Enrollment Periods

No Current Enrollment Waiting Periods

Premium Limits

No more than 150% of the standard rate

Lifetime Maximum Benefit

$2.5 million

Special Notes

To be eligible for the coverage, you must be a resident of New Hampshire; you have applied for individual health insurance within the last 6 months; you were denied for health reasons or, you were quoted a premium rate higher than a substantially similar NHHP plan; you are federally eligible and have exhausted any COBRA coverage offered.

Children’s Health Insurance Program

Through shared funding from the federal government, the State of New Hampshire provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:

Program Name

New Hampshire Healthy Kids

Website

http://www.nhhealthykids.com/

Phone Number

877-464-2447

Apply Online

Yes

Age Limits

Under 19

Insurance Carrier

Harvard Pilgrim

Length of Coverage

12 months

Residency Requirements

New Hampshire resident and U.S. citizen, refugee, asylee, permanent resident who has been in the U.S. for at least five years

Other Eligibility Requirements

Children should not be eligible for Medicaid

Pre-Existing Condition Exclusions

None

Cost

$0 for Gold Program. Monthly premium for Silver Program is based on family size and household income.

Medicaid

Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of New Hampshire:

Governing Agency

Department of Health and Human Services

Website

http://www.dhhs.state.nh.us/DHHS/MEDICAIDPROGRAM/default.htm

Phone Number

800-852-3345 ex 5254, 603-271-5254

Residency Requirements

New Hampshire resident and U.S. citizen

Federal Poverty Line Income Limits

Infant: 300% FPL
Child Age 1-19: 185% FPL
Pregnant woman: 185% FPL
Non-working parents: 49% FPL
Working parent: 61% FPL
Medically needy individual: 76% FPL
Medically needy couple: 70% FPL

Additional Resources

New Hampshire Health Care Options Matrix™ Guide

Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines New Hampshire’s public and private health care choices for individuals and groups with various demographic profiles.

Family Health Insurance Guide by HealthInsuranceFinders.com

The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.

New Hampshire: At-A-Glance

Provides all-inclusive health data of New Hampshire. Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.


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