Health Insurance & Managed Care
This category includes data on managed care enrollment, state consumer protection laws, and high risk pools.
Select a subcategory on the left to see how the indicators compare across the states. Results will be shown as a table, map, or trend graph as available.
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categories & subcategories
Health Insurance & Managed Care Indicators
Pre-Existing Condition Insurance Plans
High Risk Pools
- State High Risk Pool Programs and Enrollment
- State High Risk Pool Pre-Existing Condition Exclusion and Look Back Periods for Applicants Without Qualifying Prior Credible Coverage
- State High Risk Pool Plans with Medical Deductibles of $2,500 of More
- State High Risk Pool Sources of Funding
- State High Risk Pool Assessments on Insurers and Providers to Fund High Risk Pools
- State High Risk Pool Grants from Centers for Medicare & Medicaid Services (CMS)
- State High Risk Pool Per Member Per Month Expenses
- State High-Risk Pool Rating Rules, 2011
Protections in Small Group Markets
- Small Group Health Insurance Market Guaranteed Issue
- Small Group Health Insurance Market Rate Restrictions
- Small Group Health Insurance Market Pre-Existing Condition Exclusion Rules
- Health Insurance Subsidies in the Small Group Market, as of January 2012
- State Statutory Authority to Review Health Insurance Rates, Small Group Plans
Protections in Individual Insurance Markets
- Individual Market Guaranteed Issue (Not Applicable to HIPAA Eligible Individuals)
- Individual Market Rate Restrictions (Not Applicable to HIPAA Eligible Individuals)
- Individual Market Portability Rules (Not Applicable to HIPAA Eligible Individuals)
- Non-Group Coverage Rules for HIPAA Eligible Individuals
- Health Insurance Subsidies in the Individual Market, as of January 2012
- State Statutory Authority to Review Health Insurance Rates, Individual Plans
Insurance Market Competitiveness
data collection
Medicaid Benefits
This data collection reflects Medicaid benefits covered in each state, limitations applied to those benefits, cost-sharing charges, and the reimbursement methodologies used for those benefits as of October 1, 2010. Data for four additional points in time (January 1, 2003, October 1, 2004, October 1, 2006, and October 1, 2008.) are also available. In general, the data presented here represents a state’s policies applicable to adult Medicaid beneficiaries receiving care on a “fee for service” basis.
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Medicare Health and Prescription Drug Plans
This data collection covers private plans participating in the Medicare Advantage program and the Medicare prescription drug program.
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