Company Adds Coverage For Some Montana Uninsured

May 6, 2003 ( - Some Montana residents currently without health coverage will soon have access to limited insurance restricted to doctors' office visits and generic drugs.

The coverage, which comes from New West Health Services, will be available to the uninsured for as little as $25 per month, according to Washington-based legal publisher BNA. The policies exclude inpatient or outpatient treatment at a hospital, emergency-room services, or brand-name prescription drugs.

The Montana Department of Insurance recently estimated that about 18% of the state’s population does not have health insurance.

Before New West was able to offer the plan, the recently adjourned 2003 Montana Legislature had to exempt the company from existing state law that requires any company offering health insurance in the state to cover hospitalization and emergency room treatment. That exemption came in House Bill 384, introduced by state Representative Joe McKenney, which carried strongly in both houses and has been signed by Governor Judy Martz.

Under the test program, New West plans to enroll 1,000 Montana residents living in either Helena or Billings and to closely monitor the plan’s performance and customer satisfaction for a year, the company said. The program is scheduled to begin in July and then can be renewed in one-year increments for up to five more years. The state insurance commissioner must approve the annual renewals.

The coverage includes unlimited doctor visits, generic drugs, and routine lab work. Prescriptions without available generic substitutes are not covered under the policy but are available at a discount from participating pharmacies. The coverage comes with no deductibles or pre-existing condition exclusions. But, it does include a coinsurance clause that requires participants to pay from 10% to 30% of the costs. The level of the coinsurance payment will be set by income, but there is no income cap limiting participation in the program, the company said. Income also will be used to set premium levels, which will range from $25 to $100 a month.

To participate in the program, people must be residents of either Helena or Billings, under age 65, and uninsured for either the past six months or for seven of the past 12 months.