1600.000.00 GATEWAY TO BETTER HEALTH

1600.010.30 Uninsured

IM-40 May 1, 2012

To be eligible for Gateway to Better Health an individual must be uninsured.  Health insurance is defined as insurance that minimally provides coverage for physician’s services and hospitalization.  There is no penalty or waiting period for dropping insurance.

Health insurance does not have to cover all medical conditions (such as pre-existing conditions) to cause ineligibility.

The term “health insurance” does not include short-term, accident, fixed indemnity, limited benefit or credit insurance, coverage issued as a supplement to liability insurance, insurance arising out of a worker’s compensation or similar law, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self insurance.

An individual who has exceeded a lifetime maximum for all benefits under their health plan are considered uninsured. The applicant must provide documentation they have reached their lifetime maximum for all benefits.