What is HIPAA? What is the best route to take in order to obtain adequate HIPAA health insurance coverage in Florida? Finding HIPAA health insurance in Florida is not as difficult as you may be led to believe. Make no mistake; there are a number of important criteria that you must meet in order to be eligible for a HIPAA health insurance plan in the state of FL.
HIPAA (or the Health Insurance Portability and Accountability Act of 1996) established national standards related to health care administration and eligibility. Two of the main features of the act were concerning the rules and regulations that determined:
1. Health care privacy standards.
2. Health care eligibility and portability (transferability) of health care coverage.
To stay on the topic of how to best obtain HIPAA health insurance coverage in Florida then we will only concentrate on the second feature of the act dealing with health care eligibility and portability.
The reasoning behind the health care eligibility and portability section of the HIPAA act was to make sure that those who obtain health care coverage will be allowed by law to continue coverage even when certain circumstances change, namely employment status. The growing number of Americans that transfer jobs from a job where they had health care coverage to a job that does not offer them health care coverage or even began working as a self employed individual have a number of options available to them under the HIPAA regulations.
In a nutshell, the HIPAA act allows for anyone leaving their job that has had health care coverage for 12 months or more and then been offered a COBRA group continuation plan and exhausted the coverage under their COBRA plan (usually 18 months) to be eligible for a individual health insurance HIPAA plan that will be issued on a guaranteed issue basis (that means that there is no look back at pre-existing conditions and no strenuous underwriting requirements to meet). However, there are many important details that must be met: such as you may not be offered a conversion plan after your COBRA coverage exhausts or else you will become ineligible for a HIPAA guaranteed issue plan.
A list of some of the Florida HIPAA requirements is as follows (all of these requirements must be met):
1. You must not have any other health insurance coverage (or it will be involuntarily terminated soon – for example: the end of your 18 months under COBRA coverage is approaching soon).
2. You have been insured by creditable coverage (creditable coverage being defined as basically having a full comprehensive major medical policy and not just a plan that is supplemental in nature or insures only against accident, disability, or liability) for the last 18 months or more with no lapse of coverage of more than 63 days.
3. Your most recent coverage was under a group health plan, a governmental plan, or a church plan; or under 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 Florida service area of your prior insurer’s service area.
4. Your most recent coverage was not terminated due to nonpayment of premiums, fraud, or intentional misrepresentations.
5. You are not eligible 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.
Practically speaking, what is the best health care option for you? The answer hinges on you and your families health histories in the last 10 years. If you are healthy and do not have any major pre-existing conditions (cancer, diabetes, arthritis, heart conditions, etc.) then it will almost always make more sense for you to apply for an individual health insurance plan. This is because the premiums for a guaranteed issue HIPAA plan in Florida will generally be 110% to 200% of the premiums for the same plan that is fully underwritten on a regular individual basis. Also, not all health insurance plans in FL are HIPAA eligible; only a few.