Iowa Individual Health Insurance

Health insurance is an important defense that no person or family should be without. If you are without group health insurance coverage, purchasing an Iowa individual health plan is a great option. There are laws and regulations in Iowa surrounding these individual health policies that you should be aware of, in order to make a more informed decision.

Eligibility: How Am I Evaluated?

Individual health insurance applicants in the state of Iowa are usually reviewed based on each insurers own rules and regulations. There are no state laws or regulations that prevent an insurer from turning down any applicant and no guidelines regarding who should or should not be accepted into a private health care plan. Most private insurers take many factors into consideration when determining whether an applicant should be approved or denied, including age, health status, and the specifics of the plan.

In an effort to comply with HIPPA Group-to-Individual Portability Coverage regulations, Iowa guarantees that all HIPPA eligible consumers who are denied coverage from a private insurer will receive acceptance into the Iowa Comprehensive Health Association, the state?s high-risk health insurance pool.

Iowa Guaranteed Benefits & Pre-Existing Conditions

The state does not require medical insurance providers to carry standardized plans for consumers. Each plan is based upon what the insurer wants to offer to Iowa residents. On the other hand, the state does require all policies to cover certain benefits that include diabetic supplies and services and cancer screenings.

With pre-existing conditions, your insurer has the right to look back at your medical history for the 5 years prior to your application to determine what should be included. They can then impose a 24 month exclusionary period on those conditions. Additionally, they can include those conditions on your policy?s elimination rider, which will exclude them from your policy indefinitely. To further matters, if you make a claim for a condition not listed as pre-existing, your insurer can look back to see if it should have been diagnosed before your policy took effect. If so, then you claim can be denied.

Iowa 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 Iowa laws regarding 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, Iowa individual health insurance customers are guaranteed the chance to renew their health insurance policy at the end of its term. Your insurance policy cannot be cancelled at renewal because you have gotten sick and made claims on the policy. However, you must also be willing to pay the new premium imposed by your insurer.