Florida Health Insurance Preexisting Conditions

Are you uninsurable and looking for guaranteed issue health insurance?  Are you having difficulty obtaining quality coverage due to preexisting conditions?

Florida is not a Guaranteed Issue State, unlike New York, New Jersey, Vermont, Maine and Massachusetts. Hence, there are no truly guaranteed issue health insurance plans available to individuals (they are illegal) unless you are self employed (in which case there is open enrollment during the month of August for qualifying individuals) or coming off COBRA. Sites claiming to offer guarantee issue health insurance other then HIPAA or for self employed, are trying to mislead you. 

HIPAA Guaranteed Issue Plansindividual health insurance in Florida

These are individual health insurance plans normally offered to people who have exhausted their COBRA coverage, 18 months. However, there are additional circumstance and considerations that are applicable and you may qualify under:

  1. You do not have other health insurance (or it will be terminated involuntarily)

  2. You have been insured by creditable coverage for the last 18 months or more with no lapse of coverage for more than 63 days

  3. Your most recent coverage was under a group health plan, a government plan, or a church plan, or an individual plan that terminated due to: the insurer's insolvency, the insurer's discontinuance of all it's individual coverage in Florida; or the fact that you no longer live in a Florida service area of my prior insurer's network plan

  4. Your most recent coverage was not terminated due to nonpayment of premiums, fraud, or intentional misrepresentations

  5. You are not eligible for any coverage under a conversion plan, a group health plan, Medicare or Medicaid

  6. You accepted and exhausted any group continuation of coverage (including COBRA) that was offered to you

A person must apply within 63 days of their group plan ending.  It is best to apply before the group plan ends. A "Certificate of Creditable Coverage" is required from the prior insurance carrier to document the time period of your coverage. There are no preexisting condition clauses or Riders with HIPAA plans and acceptance is guaranteed.  However, the carriers are also allowed more latitude in the rates they charge for these plans, hence you can expect to may a multiple of the base community rate for the plan being offered. Call (407) 425-9347 to discuss how this works in your situation.

Short term medical plans such as the Secure 12x3 is perfect for people having difficulty obtaining health insurance due to prior medical conditions. You can get a health insurance plan that will cover you for up to three consecutive 12 month periods. Doctor visits covered with a $25 copay,  hospitalization, outpatient surgery etc.

To determine if you qualify for this plan please answer the following questions.
NOTE: IF “YES” IS ANSWERED ON ANY QUESTION 1 THROUGH 6, COVERAGE CANNOT BE ISSUED.

  1. Will there be any other health insurance in force on the policy date?.

  2. Is the proposed insured, spouse, or any dependent child now pregnant ?

  3. Is any proposed insured currently eligible for Medicaid?

  4. Within the past 5 years have you or any person proposed for coverage been aware of, diagnosed, treated by a member of the medical profession, or taken medication for cancer or tumor, stroke, heart disease including heart attack, chest pain or had heart surgery, COPD (chronic obstructive pulmonary disease) or emphysema, liver disorder, degenerative disc disease or herniation/bulge, rheumatoid arthritis, degenerative joint disease of the knee, insulin -dependant diabetes (not applicable to DC residents) alcohol abuse or chemical dependency?

  5. Within the past five years, has any person proposed for coverage tested positive for the HIV infection, or been been diagnosed as having Acquired Immune Deficiency Syndrome (AIDS), or AIDS related complex (ARC), caused by hte HIV infection or other sickness or condition derive by such infection?

  6. Has any person proposed for coverage not been a legal resident of the United States for the last 12 consecutive months?

    7.

You can apply for three consecutive 12 month coverage periods, up to a maximum of 36 months in all.

This plan is ideal if you are waiting for a guaranteed issue plan to start and reduces your exposure to loss by being without coverage during the interim. Secure 12x3 STM - Click here to see rates, benefits and apply for coverage. It is an affordable short-term medical coverage alternative for many.

Eligibility:

Secure 12x3 STM is offered to members and their spouses under 65 and their dependent children under age 19 (or under age 25 if a full-time student) who have a social security number and can answer 'no' to the health questions on the application. Children age 19 and over should apply separately. Child-only coverage is available for ages 2 through 18.

Featuring...

Coverage Available within 24 hours.
 
 The insurance can be effective as early as 12:01 a.m. the next day after the transmission date. However, the applicant can choose a later effective date not to exceed 60 days from transmission date. Coverage ends on termination date listed in your policy.

To get a quote click here Secure 12x3 STM

Value Med Insurance Plan  - This is also a great supplemental plan for people with a high deductible health insurance plan. The Value Med Plan is a very affordable Limited Benefit Health Insurance Plan that far exceeds in value any comparably marketed product in Florida today. From these links you can review benefits, check rates and apply for instant coverage. Adding one or "stacking" several of these Limited Benefit Plans to your existing High Deductible Health Plan (HDHP) is a much more cost effective way of "lowering" your major medical deductible.

To see plan details and get a quote Value Med Insurance Plan

To determine if you qualify for this plan please answer the following questions.   If you can answer No to these questions you qualify.

  1. Within the past 12 months has any person to be insured been confined to a hospital, nursing home or other medical facility?

  2. In the past 24 months has any person to be insured been diagnosed or treated by a medical professional for a heart condition, stroke, internal cancer or malignant melanoma, chronic obstructive lung disease, insulin dependent diabetes, chronic liver or chronic kidney disease?

  3. Has any person to be insured tested positive for exposure to the HIV infection or been diagnosed as having ARC or AIDS?

Some Plan Information

Sickness & Accident, Hospital & Medical Insurance

THIS POLICY PROVIDES LIMITED BENEFITS

 

• Benefits are Paid Directly to You

• No Deductible or Co-pays

• Pays Benefits in Addition to any Other Insurance

• Issue Ages 18 through 64

• Dependent Child Coverage Available to Age 19 or 25 if   a Full Time Student
• Guaranteed Renewable to age 65

• Use any Doctor, Hospital or Licensed Provider

• Preexisting Conditions Incurred within the 12 Month   Period Preceding the Effective Date are Covered after   12 Months

• Your Rates Cannot Increase Due to Your Advanced   Age or Declining Health

 
 

VALUE MED PLAN

BENEFIT SCHEDULE

PAYS

Doctors Office Visits

Pays up to 10 Doctor Office visits per calendar year for each insured adult and up to 5 per calendar year for all insured children combined. Doctor Office visits are limited to one per week, except in Maryland.

$75 per visit

Hospital Outpatient Visits

Pays for Doctors treatment, medical supplies, x-ray and lab tests. Outpatient Benefit maximum per calendar year is $1,000 per insured and $1000 for each covered child.

Up to $250 per visit

Ambulance Services

Pays ambulance expense per sickness or accident

$200 maximum per sickness or accident

Hospital Confinement

Pays $100 per day, beginning on the 1st day of hospital confinement, up to 365 days. Option for $500 per day is available.

$100 or $500
Included at no charge: discounts at over 55,000 pharmacies for your prescription drugs as well as lab tests and x-ray imaging services
* The benefits may be paid directly to the hospital or other health care facility if an assignment of benefits is made by the policyholder.
** Pre-existing conditions are those medical conditions disclosed or not disclosed on the application which were diagnosed or for which medical advice or treatment was recommended or received from a Doctor within a 12-month period immediately preceding the Effective Date of Your coverage. Any loss due to a pre-existing condition is not covered unless the loss begins more than 12 months* after the Effective Date of coverage. *The pre-existing condition waiting period is 6 months in Idaho and Oregon.
Please Note this Policy contains a 10-Day Right to Examine Coverage:
You may cancel coverage under this Policy or Certificate within 10 days of receiving it by returning the Policy or Certificate to Us. If it is returned for cancellation, we will refund any premium paid for your coverage.

Value ER Plan - This is also a great plan for people with a high deductible health insurance plan

To see plan details and get a quote Value ER Plan

Some Plan Information

24 Hour Emergency Room
Coverage for Sickness & Accidental Injuries
 

• Discount & Savings - Earn dividends through The   Dividend Club Merchandise, Travel, Entertainment and   more

• Family Keys Program - Unique Software that helps   you organize your personal and financial information

• Benefit provides up to $1,000.00 per Hospital   Emergency Room visit, up to 2 times per year - per   family (Benefits are subject to a $100 deductible)

• Affordable monthly cost of $20 for Single or Family   Coverage

• Issue Ages Through Age 69

24 Hour Accident Coverage  - 

Some Plan Information

Accident Expense Coverage for Members and their Families

 

• Pays 100% of Covered Medical Expenses after satisfaction of the $100 or $250 Deductible up to the coverage maximum

•Benefits are paid directly to you

•Use any doctor or hospital

•Accidental Death & Dismemberment benefits

•Emergency Helicopter Air Ambulance benefits

• Automatic acceptance through age 69

 

Florida Temporary Health Insurance | Florida Dental Insurance | Florida Disability Insurance | Supplemental Insurance | Health Insurance Tips | Travelers Health Insurance | Florida Medicare Supplements |  Florida HSA Plan | Florida Group Health Insurance|


Peter C. Hegeman, Agent
Phone: 407-425-9347
Fax:     407-423-7483

Return to Florida Health Insurance Main Page