Guaranteed Health Insurance Explained
What is Guaranteed Issue Health Insurance
Guaranteed or guaranteed issue health insurance simply means that you cannot be denied coverage regardless of your medical status. There are generally no health questions on applications for guaranteed issue health insurance and everybody is accepted.
Some plans are what I would call an almost guaranteed issue plan. They do ask a few questions but reward you with better coverage at a lower premium. Many times I can get someone covered even if they do not get accepted for full major medical.
Who Needs This Type of Coverage?
If you have been declined for health insurance due to a medical condition (one that is present or from the past), you need a plan that will ignore your medical history.
In some instances, individuals are accepted but the health insurance carrier has excluded important coverage. At times these exclusions can become absurd.
For example, many companies will totally exclude any problem with your gastrointestinal system if you have had a single polyp show up in a colonoscopy.
In some instances the exclusion rider is no big deal but in others it is a “show stopper”.
Covering Pre-existing Conditions
Guaranteed issue health insurance will either cover pre-existing conditions within 12 months. But, even if the condition is initially excluded, it will not be permanent.
These plans do not cover pregnancy so don't even bother to ask.
Types of Guaranteed Issue Health Insurance
Group Health Insurance
Group health insurance is always guaranteed issue. Sometimes they can adjust rates upwards due to prior medical issues. But that is generally limited to 15% or less.
In Florida, the month of August is the open enrollment month for groups of one. A self-employed person can purchase a guaranteed issue group plan during this month only. The plans have an effective date of October 1st.
We have group health insurance plans for self-employed individuals that can be started any month of the year. Generally, the special plans we offer are less expensive than those offered by other companies. For more information on this, go to Group Health Insurance Plans for Self Employed.
Limited Benefit Health Insurance
Aside from group health insurance, individuals can purchase a limited benefit plan at any time.
These plans are not full major medical products. Instead, they pay out according to a schedule of benefits. For example, a plan may pay $1,500 a day for a hospitalization or $100 for an office visit.
It is important to note that the amount paid has nothing to do with what you are charged or the reason for your hospitalization, office visit or test. It is a fixed reimbursement that will paid to you or the provider.
For many, this is the only type of health insurance they can obtain. If, in the future, you are eligible for a regular major medical plan, the time spent on these plans counts as “credible coverage”. This means that your pre-existing conditions may be covered with no waiting period.
If you have no other choice, believe that you will be covered by a group plan in the future and have a medical issue, this could be an excellent choice to keep your coverage going.
COBRA
If you have group health insurance through your employment and lose your job, you might be eligible for COBRA. This is a continuation of your group coverage. The difference is, the employer is not making any contributions toward the cost. Generally, you can continue this coverage for 18 months.
At the end of the COBRA period, if you cannot obtain traditional health insurance, you may be eligible for a continuation plan to extend the benefits.
The Future
Congress has passed legislation that will permit everyone to obtain health insurance in 2014. It will cost a fortune but you will be able to obtain it.
Thanks
Martin Unger
800-272-0512
If you would like a personal quote give me a call. I am here from 9 AM to about 8 PM. You can reach me at 800-272-0512.
FLQUOTE.COM - A Full Service Insurance
Florida agency
Coral Springs, Florida 33076
1-800-272-0512
1-954-757-0033