New Hampshire Health Insurance

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Hello New Hampshire resident! You have a variety of health insurance options to choose from, whether you are looking for coverage for yourself or for your family, whether you have a preexisting health condition or are switching plans. To help you figure out what plan to pick, we’ve put together the below guide to get you acquainted with what type of coverage is available to you. We hope that your search for a great carrier will be made easier after you’ve read this article.

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New Hampshire Policies on Individual Health Plans (NH)

Getting a health plan for yourself in New Hampshire is relatively straightforward. You can choose a group policy, such as an HMO, PPO, POS, or HSA network. These plans are cost-effective, but have restrictions, such as only allowing you to visit doctors within their networks. If you have more specific health needs, individual health plans are available, but more costly. No matter which type of coverage you choose, it is important you are aware of the following:

  • Individual health insurance providers can refuse to cover you based on a health problem, even if you are HIPAA eligible.
  • New Hampshire carriers have the right to search the last 3 months of your medical history for preexisting conditions.
  • Preexisting health problems may lead a medical insurance company to add an exclusion rider to your policy, and to exclude the health condition from coverage for up to 9 months.
  • Be aware that in NH, pregnancy can be considered a preexisting condition.
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Family Medical Coverage in New Hampshire (NH)

Just as with individual health coverage, family medical insurance can be divided into two types, group and individual. And just as with individual health insurance, there are certain state regulations that affect the type of coverage you can receive. Below are some important terms you may come across when searching for a health plan:

  • Nondiscrimination – Group health plans are available to every qualified applicant in New Hampshire, no matter if there is a health problem and no matter if they enrolled late; they also cannot be charged more because of a health problem.
  • Look-back Period – This is when insurance companies can review your medical history for pre-existing conditions. In NH, this period is three months for fully insured policies and six months for self-insured ones.
  • Exclusion Period – Group health insurers can impose a limited exclusion period for pre-existing conditions. If you have had continuous coverage, with a lapse of no more than 63 days, you are entitled to creditable coverage toward your exclusion period.

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New Hampshire Health Care Options for Pre-Existing Conditions

If you have a pre-existing condition, such as diabetes or cancer, you may have trouble getting a health insurance policy in New Hampshire. Luckily, the state has some programs and regulations in place to help individuals who have been denied coverage elsewhere.

  • Mandated Benefits – In New Hampshire, certain benefits must be included in the health policies sold to consumers. These types of benefit are only included in group health insurance and can include preexisting conditions if acceptable by the insurance company.
  • HIPAA (Health Insurance Portability and Accountability Act of 1996) – This federal act has helps to improve access to group health insurance and offer hope to those who have been unable to obtain health insurance due to preexisting conditions. The HIPAA states that the only acceptable exclusions are for those preexisting conditions for which medical advice, treatment, care or diagnosis has been within six months prior to coverage.
  • Preexisting exclusions – Pregnancy is not considered a preexisting condition in New Hampshire. Preexisting conditions can also not be applied to newborns or adopted children.
  • Portability Law – Insurance companies are required to credit prior coverage against the preexisting condition waiting period. This is effective only if previous coverage was less than 63 days prior to the current insurance coverage.
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The above list is only an abbreviated selection of the rules concerning health insurance for people with preexisting health problems. For more details, contact the New Hampshire Department of Insurance.

Changing Health Plans in New Hampshire (NH)

Moving to New Hampshire? Concerned about what to do after losing employer-provided health insurance? We’ve compiled a brief list of programs and laws that may apply to you:

  • COBRA – COBRA can help you to keep the coverage you had at your previous job for a certain amount of time. Only certain people are eligible for COBRA, however.
  • New Hampshire Health Plan – If you have exhausted your COBRA coverage and are HIPAA-eligible, you will be able to get coverage under the New Hampshire Health Plan, a state-run high risk pool. Even if you aren’t HIPAA-eligible, you may still qualify to be part of the pool.
  • Employee Coverage – If you’ve just gotten a job in New Hampshire, be aware that employers in this state are not required to give you health insurance. If they do, they have the right to impose a waiting period on when your benefits take effect.
  • Non-government Workers – Some non-government employers are not subject to New Hampshire’s group health insurance regulations. Check with the NH Dept. of Insurance for more information.