Individual Health Insurance Laws
- Understand individual health insurance laws.healthcare concept image by Stasys Eidiejus from Fotolia.com
Generally, individual health insurance is subject to laws that are common or similar from state to state, with small differences being made depending on the state you live in. These laws normally affect what insurance companies can and cannot do when issuing health insurance policies. Some laws may also outline an individual's responsibility when it comes to paying premiums and keeping the policy in force. - Pre-existing condition exclusions are common in individual health insurance. Although these laws vary by state, many states allow insurance companies to exclude pre-existing conditions for a certain period of time. Some states, like Florida, can permanently exclude pre-existing conditions or refuse to sell the individual a health insurance policy altogether. After the exclusionary period has passed, the insurance company must treat the health condition. The definition of a pre-existing condition can vary by state as well. In some states, a pre-existing condition is a condition which the insured has been diagnosed with prior to applying for health insurance. For example, cancer (even if it is in remission), diabetes, or even a back injury may be classified as a pre-existing condition. In other states, there is a time limit placed on the diagnosis or treatment. For example, if an insured is diagnosed six months prior to applying for a new health insurance policy, then the insurance company can exclude that condition from the health insurance policy. However, if you are switching your health insurance policy to a new policy with no lapse in coverage, you will be able to bypass the exemption because the old policy will credit time towards the new policy's exclusion period.
Exclusion periods can vary significantly from state to state. Some states allow no exclusions at all, while other states allow up to two years for insurance companies to exclude pre-existing conditions. - Many states offer a guaranteed renewability feature. This provision guarantees that you will be able to renew your policy regardless of your health. This is important if you want to be able to renew your policy and are worried about doing so because of a health condition you've developed while your current policy is in force.
- Some states mandate coverage for minors. These states will require that newborns, for example, be automatically covered under the parent's policy for 31 days after the child is born. This provision often extends to handicapped children as well. Handicapped provisions also often do not limit coverage to normal age limits for minors in the state where they live.
- Some states offer temporary insurance offerings if you become divorced or lose your job and have exhausted your COBRA benefits. These regulations mandate that insurance coverage be offered to you under a special state-sponsored insurance plan.
