High-Risk Pools

A high-risk pool is a State-operated program that offers health insurance to individuals who don’t have access to coverage through an employer or other group and have a serious medical condition that prevents them from purchasing private health insurance. It is similar to risk pools for automobile insurance to ensure coverage for people who can’t get it elsewhere. In most States, the risk pool is funded through premiums, supplemented by tax revenues or by an annual assessment on health insurance companies operating in the State.

More than 30 States have established high-risk pools that provide access to comprehensive health coverage for more than 180,000 people across the country. An estimated 1 million people who are eligible for coverage in high-risk pools don’t participate. In a few cases, States don’t have adequate funding for the pools and are unable to enroll all eligible individuals.

To find out if coverage through a high-risk pool is an option in your State, contact your State Insurance Commissioner. Check the blue pages of your local phone book for contact information.