Florida Individual Health Insurance
Health insurance is an indispensable precaution that allows your family to take care of basic medical needs without financial worry. Although it may be a little more costly than group coverage, Florida individual health insurance is a perfect solution for those who lack any other coverage. There are laws and regulations in Florida surrounding these individual health insurance policies that you should be aware of, in order to make a more informed decision.
Eligibility: How Am I Evaluated?
Generally, a health insurer has the flexibility to decide how applications are handled and who gets accepted for a policy. Many insurers use factors such as health status, age, and lifestyle habits to decide who they will cover. There are no real regulations on why an applicant can be turned down and an insurer can deny you for almost any reason. The only exception is for breast cancer patients, who cannot be turned down provided that they completed treatment at least two years prior to their application.
In response to HIPPA Group-to-Individual Portability Coverage regulations, Florida does require private insurers to guarantee issue of health insurance to HIPPA eligible customers through a conversion policy.
Florida Guaranteed Benefits & Pre-Existing Conditions
For the most part, insurers are not required to include specific policies in their selection of plans. There are no laws in Florida that mandate standardized policies for individual health insurance. That being said, there are a few benefits that all insurers are required to cover under all plans, such as childhood immunizations, mammograms, and diabetes treatment.
The following regulations apply to pre-existing conditions:
- HIPPA eligible consumers cannot have exclusion periods and elimination riders imposed on their policy.
- Pre-existing conditions can be included in an elimination rider attached to your policy, which will exclude them from coverage under the policy forever. The only exception is breast cancer, which cannot be included on an elimination rider if you completed treatment at least 2 years prior.
- Pre-existing conditions can also be included in an exclusionary period of up to 2 years. To determine what is a pre-existing condition, insurers can look back in your medical files up to 2 years prior to your application. Any condition that you did or should have sought medical advice or treatment for can be considered a pre-existing condition.
- If, within the first 2 years of your policy, you make a claim regarding a condition that was not listed as pre-existing, your insurer can check back 2 years prior to your application to see if it is something that should have been listed as pre-existing. If so, then your claim can be denied.
Florida Individual Health Insurance Premiums
Premiums are determined at the discretion of the insurer and are usually based on individual factors, such as age, health status, and family size. There are no Mississippi laws that state what you can or cannot be charged for a policy. Essentially, an insurer can charge you what they want to and if you are older or have a medical condition, you will likely pay more for your insurance coverage.
Finally, your insurer is also allowed to raise your insurance premiums; however, the good news is that your insurer cannot cancel your policy because of an illness and they can?t deny you the chance to renew your policy, unless they have discontinued the policy type for all customers or have withdrawn from the individual market altogether.