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MCHA
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The Montana Portability
Plan
Guaranteed
Health Insurance for Individuals Leaving Group Coverage
Federal Law (The Health Insurance Portability and Accountability
Act) or HIPPAA and state law provide a way for individuals leaving
group health insurance plans, including COBRA coverage, to get
individual health insurance that covers all pre-existing conditions.
Montanans can obtain this guaranteed "portability"coverage
through the Montana Comprehensive Health Association (MCHA).
Who qualifies for MCHA Portability Plans?
Anyone who has an aggregate of 18 months or more of "creditable"
prior health coverage and is leaving an employer-sponsored group
health plan, a health benefit plan offered to government employees,
or a church plan.
What is "creditable coverage"?
Self-funded group health plans, any health insurance coverage,
Medicare, Medicaid, Indian or tribal health services, MCHA coverage,
a public health plan, and benefits offered through the Peace Corps,
in essence, most kinds of comprehensive health plans are creditable
coverage. Excluded is coverage with very limited benefits, like
policies covering only cancer, the medical coverage that is part
of auto insurance, or worker's compensations insurance. It's important
to note that as a person accumulates their 18 months of creditable
coverage there cannot be more than a 63 day break in coverage.
Who does NOT qualify?
Anyone eligible for other employer-sponsored group coverage, Medicare
or Medicaid, or who has other health insurance.
What kind of Portability Plans are available?
There are two comprehensive major medical plans available with
the same benefits, but different cost sharing features:
|
Option
1 |
Option
2 |
| *Deductible: |
$ 500 |
$ 2,000 |
| *Insured's
Copayment |
30% |
0 % |
| *Annual
liability |
$ 2,500 |
$ 3,000 |
| *Lifetime
benefit |
$ 1,000,000 |
$ 1,000,000 |
Both plans include a prescription drug benefit (with no annual limit)
that is administered through a drug card program. A mental health
and chemical dependency benefit meeting the state's mandated limits
is also included. All pre-existing conditions are covered immediately.
How to sign-up?
Contact the Montana Comprehensive Health Association at 1-800-447-7828
extension 8537 or 444-8537. (The administering carrier for the MCHA
is Blue Cross and Blue Shield of Montana.) They will help determine
if you are eligible, and send you an application, brochure and rate
card. Questions or concerns about the MCHA can also be directed
to the Montana Department of Insurance by calling (in-state) 1-800-332-6148
or 444-2040.
Traditional coverage through MCHA still
available:
The MCHA will continue to provide health insurance to individuals
that have been denied coverage entirely or denied coverage for certain
health conditions. Call the MCHA at 1-800-447-7828 extension 8537
for more information.
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