Washington Individual Health Insurance
Health insurance is a valuable for your peace of mind. Having proper health coverage can save you and your family from huge medical bills in case of physical emergencies. Although it may be a little more costly than group coverage, Washington individual health insurance is a perfect solution for those who lack any other insurance protection. As a Washington State resident, you should educate yourself in the state laws and regulations that affect these individual health plans.
Eligibility: How Am I Evaluated?
In Washington individual health insurance applicants are evaluated using a "health screen". When you apply for health insurance, you will complete a health questionnaire and are awarded points for each answer you give. Most questions will center on any past or current medical conditions and lifestyle habits. Under Washington law, those whose health screens fall under 325 points cannot be turned down by the health insurance provider. On the other hand, those whose health screens tally more than 325 points can be turned down if the provider chooses.
Aside from being turned down if they score too highly on their health screen, the only other way that health insurance applicants can be turned down if the provider already has too many customers enrolled and will not have the capabilities to service new enrollees. The provider's claim must be confirmed by the Commissioner of Insurance.
To comply with HIPPA Group-to-Individual Portability Coverage regulations, Washington State can guarantee issue of an individual health insurance policy to those who qualify; however, the provider can give HIPPA eligible customers as little as two policies to choose from. These individuals also do not have to take a health screen, since they are protected under HIPPA regardless. As an alternative, HIPPA eligible consumers can also purchase a health plan from the Washington State Insurance Pool (WSHIP).
Washington Guaranteed Benefits & Pre-Existing Conditions
Almost all policies are required to cover certain types of mental health benefits under Washington State law. Aside from certain basic benefits such as mammograms and medical care for pregnant women, what your health insurance plan covers will depend on what type of policy you select. In regards to pre-existing conditions, insurance laws in Washington State allow an insurer a look back period of 6 months and an exclusionary period of 9 months, if the consumer has been uninsured for more than 63 days leading up to the application. This means that an insurer can look at your health history over the past 6 months to determine what pre-existing condition should be defined and then exclude those conditions from your policy for up to 9 months. Pregnancy can be deemed a pre-existing condition. If you are HIPPA eligible, you will not have to worry about any exclusion.
Washington Individual Health Insurance Premiums
Individual health insurance rates in Washington State are determined by your age, number of people covered under your plan, and other individual factors. Insurance companies cannot give you a higher rate simply due to your health status and this status is not supposed to be taken into consideration when determining your rate. As long as you are not being charged more than other customers due to your health status, then the company may legally set their premiums as high as needed. It is important to note that health insurance in Washington State has a guaranteed renewability clause, which means that you will be able to renew your health insurance at the end of your plan's term, as long as you have handled everything in good faith (i.e. paid your premiums, haven't lied to the company, etc). In effect, your insurance company may charge more for the high-risk status.
Health insurance acts as a financial shield against high medical expenses and ensures the well-being of your family. Consult with a qualified broker/agent near you to avail the benefits of health insurance alternatives.
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