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Michigan Individual Health Insurance

Health insurance is essential for the physical well-being of you and your family. If you don't get group health insurance through your employer, then you should look into purchasing Michigan individual health insurance from a private insurer. Since you are considering individual health insurance in Michigan, you may want to know more about the Michigan laws regulating individual policies.

Eligibility: How Am I Evaluated?

Generally, individual health insurance applications are not regulated by the state and applicants can be denied for any reason. Insurers in Michigan have the flexibility to evaluate each applicant based on factors defined by their own rules and regulations. These factors may include age, number of people seeking coverage under the policy, and past medical history. The only exceptions to this are for Blue Cross and Blue Shield applicants or those who apply for an HMO policy during the company's 30-day open enrollment period. These applicants are guaranteed issuance of a policy. In addition, Blue Cross Blue Shield of Michigan cannot raise your insurance premiums because of your health condition.

In accordance with HIPPA Group-to-Individual Portability Coverage regulations, Michigan guarantees issuance of health insurance via Blue Cross and Blue Shield of Michigan, the state’s insurance carrier of last resort, to HIPPA eligible consumers who have been unable to obtain a policy from a private provider.

Michigan Guaranteed Benefits & Pre-Existing Conditions

What your individual health insurance policy covers will depend on which plan you choose to buy. Insurers are allowed to tailor their plans as they see fit and offer the benefits that they want, for the most part. There are a few benefits that all insurers are required to cover for all customers under Michigan law. These benefits include things such as mammograms, diabetes care and continuity care for pregnant women.

Pre-existing conditions are tightly regulated in Michigan, as opposed to many other states. Under Michigan law, HIPPA eligible consumers who have a Blue Cross and Blue Shield plan cannot be subject to pre-existing condition exclusions. Thos who are not HIPPA eligible but have a Blue Cross and Blue Shield plan or an HMO plan can only be subject to pre-existing condition exclusion for up to the first 6 months of their policy. Everyone else can only be subject to pre-existing condition exclusions for up to the first 12 months of their policy. When determining what should be considered a pre-existing condition, insurers can only look back in your medical history up to 6 months prior to your application.

Michigan Individual Health Insurance Premiums

What you are charged for a Michigan individual health insurance policy is up to the insurer. Factors that many insurers take into consideration include age, health status, plan type, and family size. Insurers can use any of these factors to quote you a higher premium rate. The only exclusion to this is for Blue Cross and Blue Shield customers, who will not be charged more due to their health status or age. Additionally, your insurer is also allowed to raise your insurance premiums; however, your insurer cannot cancel your policy because of an illness and they can't deny you the chance to renew your policy.

Before zeroing on a particular health insurance policy, you need to know exactly what is and isn’t covered in your policy and how much you will pay in your premiums. Get in touch with a qualified broker or agent who can help you in determining the health plan coverage suitable to you and your family's; healthcare needs.

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