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Thirty four states operate or sponsor state health insurance risk pools, which offer health insurance similar to that offered by major employer group plans at higher-than-market-range premiums.
High-risk pools are for:
- People who cannot get health insurance at all.
- People who cannot get health insurance at reasonable rates.
- People who cannot get health insurance without prohibitive preexisting condition limitations.
At least 11 or 12 states further subsidize discounted premiums for people who meet state low-income eligibility levels.
Many state risk pools offer several plans, including Fee-for-service (Indemnity), PPO and HMO options, as well as variations for location or amount of desired deductible.
One or two pools exist only for portability purposes under HIPPA, while at least two are continually or often closed to new patients due to funding shortages. State insurance agencies and risk pools have more details.
People Who Are Eligible For Medicare
Many, but not all, pools ban enrollment of Medicare eligibles. Of those that do allow them, some (but, again, not all) offer premium discounts because Medicare is primary payer. Yet a few states that do cover Medicare eligibles offer them only a standard Medigap plan. Drug coverage in those pools with Medicare supplements often does not supplement Part D for non-Extra Help patients.
Payment of Premiums Other Than By The Patient
Some risk pools have laws or rules prohibiting the use of funds other than the patient's own to pay premiums---while some do allow payment by corporate Patient Assistance Programs, ADAP/Ryan White programs, or sources other than public agencies or employers. But even so, many effectively still inhibit third party premium payments by requiring payment only via automatic debits from patients' own bank accounts.
To Find Information About The High-Risk Pool In Your State
See: www.naschip.org/ 
For contact information for your state insurance agency, see: www.naic.org .
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