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Taxonomy: High Risk Health Insurance Pools

Private, self-funded health insurance plans established by state legislation to serve middle-income, high-risk individuals who do not have access to group insurance through an employer and can afford to buy insurance but have been denied coverage in the individual health insurance marketplace because of a preexisting health condition. Although the health benefits vary, most are comparable to basic private market plans except for the cost. High risk pools charge a higher premium, typically 125 to 200 percent of the average premium for individual health insurance on the open market, and vary the premium based on the individual’s age and other factors. People apply for high-risk pool coverage through an insurance agent or directly with the state, generally have a choice of health plan options, and once enrolled, use their benefits just like any other consumer of private insurance coverage. Not all states have risk pools for people who are uninsurable.

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