Florida Health Insurance

Are you having difficulty obtaining a major medical health insurance plan due to preexisting conditions, or is your COBRA ending? 

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If you have a preexisting condition that you want covered you must understand that you are going to have to do some homework. Your options may be limited, depending on the condition and there may be some compromises ahead of you that you must be willing to consider.

Not all companies Underwrite medical conditions the same way.

Get to know the different carriers of Florida health insurance and how they treat your preexisting medical condition.  There are companies that do not place Exclusionary Riders on prior medical conditions and typically rate-up (or increase) your base premium to offset the additional risk associated with your medical condition.  Other companies will simply place what is called an "Exclusionary Rider" on your policy and/or rely the preexisting condition clause in the boilerplate of the policy to exclude your prior medical problems.  Many times these Riders are for the life of the policy, other times they are only temporary and for a year or two. The number of companies that don't exclude prior medical conditions is small and of those that don't you must have had continuous coverage from a prior medical plan otherwise you will have to wait one year, even with these rare companies, before they cover your condition. 

If you are from up north all this might sound terribly unfair and with all the buzz going on in Washington these days we may see we're in for some big changes as to how the insurance companies do their screening, but as it stands now it's their ball game!  Bear in mind, 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 unless you are self employed or coming off COBRA.  Don't believe all the hype you read about "Guaranteed Issue" health insurance.  These are LIMITED BENEFIT PLANS and they are yanking your chain unless they are referring to employer related coverage...call us if you have questions.  (407) 425-9347

HIPAA should be a last resort

If you are coming off COBRA and meet the conditions itemized below you can qualify for HIPAA which is a continuation of COBRA.  You will find however, that HIPAA is even more expensive then COBRA. So unless you have some pretty major preexisting conditions don't waste your time even considering HIPAA.

The rates on a HIPAA plan are more then double those of a typical major medical plan (at a minimum!). Most plans are high deductible health insurance plans. All insurance companies doing business in Florida offer them however the health insurance company is only required to offer two (2) of their most popular plans. So the selection of plans is not great.

 HIPAA (Health Insurance Portability and Accounting Act) a continuation of COBRA

These are individual health insurance plans normally offered to people who have exhausted their COBRA coverage, 18 months. In order to qualify you must be able to answer yes, to the following six questions.

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 and we can help you find coverage.

A better, less expensive option to HIPAA if you are in reasonably good health and have been declined for medical reasons is a Temporary health insurance plan.

Short term medical plans such 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.

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 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, 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 HIV infection or other sickness or condition derived 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?

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.  

There are also guaranteed issue plans available in the high risk pool sponsored by the U.S. government if you have been without coverage for 6 months. 

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