Eligibility Requirements
Coverage is available to persons under any one of three separate sets of rules:
Under the high risk rules a person is eligible for coverage if the person:
- has been for the past 12 months and continues to be a resident of the State of Alaska;
- is not eligible to be covered under a small employer (2-50 employees) health insurance plan;
- is not eligible for medical coverage under a federal or state program including Medicaid or Veteran's benefits, or Native Health Care.
- is not eligible for coverage under another health benefit program including a self-insurance plan, health care trust or welfare trust.
- does not have other health insurance coverage.
- has received from at least one health insurer a notice of rejection for health insurance dated within the last six months;
- has received restrictive riders that substantially reduce coverage;
- has one of the conditions listed below.
at least one of the following:
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Acquired Immune Deficiency Syndrome (AIDS) Alzheimers Angina Pectoris Anorexia Nervosa Arteriosclerosis Obliterans Artificial Heart Valve Ascites Brain Tumors Cardiomyopathy Cerebral Palsy Chronic Pancreatitis Cirrhosis of the Liver Coronary Insufficiency Coronary Occlusion Crohn's Disease Cystic Fibrosis Dermatomyositis Diabetes Epilepsy Friedreichs's Disease Heart Disorders Hemophilia Hepatitis C (Active) HIV+ Hodgkin's Disease Huntington's Chorea Hydrocephalus Intermittent Claudication Kidney Failure Lead Poisoning with Cerebral Involvement Leukemia Lupus Erythematosus Disseminate |
Malignant Tumor (if treated or has occurred within last four years) Mental Retardation Metastatic Cancer Motor or Sensory Aphasia Multiple or Disseminated Sclerosis Muscular Atrophy or Dystrophy Myasthenia Gravis Myotonia Obesity - Morbid Open Heart Surgery Paraplegia or Quadriplegia Parkinson's Disease Peripheral Arteriosclerosis (if treatment within last three years) Poliomyelitis Polycystic Kidney Polyarteritis (periarteritis nodosa) Postero-lateral Sclerosis Psychotic Disorders Rheumatoid Arthritis Sickle Cell Anemia Silicosis Splenic Anemia (True Banti's Syndrome) Still's Disease Stroke (CVA) Syringomyelia Tabes Dorsalis (locomotor ataxia) Thalassemia (Cooley's or Mediterranean Anemia) Topectomy and Lobotomy Ulcerative Colitis Wilson's Disease |
Even though you may be covered by Medicare, you may still be eligible for coverage under this plan.
Under the federal rules a person is eligible for coverage if:
- the person is domiciled in the State of Alaska;
- the person has at least 18 months of prior health insurance coverage without a 90 day or more break in such coverage;
- the person's most recent health insurance coverage was under a group plan;
- the person is not eligible for other group health insurance coverage including Medicare, Veteran's benefits, Native Health Care or Medicaid.
- the person's most recent health insurance coverage was not terminated due to nonpayment of premium or fraud;
- the person has elected and exhausted any COBRA or similar coverage;
- the person does not have other health insurance coverage.
- they are a displaced worker under the Trade Adjustment Assistance Act;
- they receive a pension managed by the Pension Benefit Guaranty; and
- eligibility for HCTC has been determined by the federal HCTC program.