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If you are buying health insurance for the first time, it is very common to find a number of problems. This section is designed to guide you through the common problems you might face when you are going to buy health insurance. You will also get an idea about the common terms you might face. Find out whether an insurer can deny you cover based on pre existing conditions and if you can renew your policy. Also find out what happens to your policy if you get married or divorced.
- Pre existing conditions
This refers to a medical or mental health condition you might have that is diagnosed before your covers start.
- Waiting period before coverage
You may face this term if you are buying covers for yourself or have been diagnosed with a pre existing condition. This may vary between 6 months to a year and depends on the state you are staying in. It refers to the period of time you have to wait before your carrier starts covering you. Of course, the rules are different if you are applying for covers under a group plan. If you have had insurance for the preceding 12 months on a job and you decide to change jobs, the new group plan will provide you cover without a waiting period. If you can’t show coverage for the preceding 12 months, the most you have to wait for is 12 months.
- Exclusionary medical waiver
The carrier may modify covers provided to you by excluding covers for particular medical conditions. For instance, many carriers deny maternity benefits to people who are buying health insurance individually.
- Denial of coverage due to pre existing condition
The insurer can deny you coverage because of a pre existing condition. However, each case is treated differently by the carriers and generalizations may not be the order of the day.
- Can the policy be renewed?
Usually, you can only avail of health insurance for a limited period. If you policy provides you with guaranteed renewability, it means that you can renew the policy when the coverage ends. Remember, the premium may change with the renewal in the policy. According to federal laws, the employer sponsored plans and plans which have state licenses are bound to give you the renewability option. Policies which are non renewable are typically those which provide short term coverage. With these policies, you will have to re apply for covers once your coverage period end.
- Health insurance after you get married or divorced
The different events in your life may influence your health care needs. Marriage, divorce, child birth or an adoption may all require modifications to your existing health plans. These may also start off special enrollment periods so that you can adjust your plans to the changed needs in your life.
You should be allowed a period of 30 days from the said event during which you can change your status. In case you miss this chance, you may have to wait another year for another open enrollment period.
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