How to get Florida health insurance coverage for pre-existing conditions is dependent on several factors that will be covered in this article. The time period for the diagnosis and treatment of your pre-existing condition can affect how you get health insurance coverage in Florida, as can the length of time you maintained continuous coverage. Although it may seem daunting to get health insurance coverage for a pre-existing condition here in FL, there are options available.
What Is A Pre-Existing Condition?
A pre-existing condition can relate to either a mental or physical condition and is defined by something for which you sought medical advice, received care, or had a treatment recommended by a health care provider. Typically a pre-existing condition is anything mentioned above that occurred within two years prior to beginning a new health insurance policy. “Pre-existing condition exclusion” is a limitation of health care benefits for a pre-existing condition on a new health insurance policy. In addition to placing Exclusionary Riders for pre-existing conditions on insurance policies, health insurance companies can increase premiums or decline coverage all together.
HIPPA, COBRA, And Medicaid/Medicare
The introduction of HIPPA (Health Insurance Portability and Accountability Act) came into effect in 1996 and became an aid to individuals in several ways, including placing limitations on pre-existing condition exclusions. In order to qualify for HIPPA, you must not have any other insurance and you must have exhausted your COBRA (Consolidated Omnibus Budget Reconciliation Act) benefits. COBRA is available for up to 18 months provided you apply for it within 63 days of your previous policy terminating. Furthermore, you must not be eligible for a group health plan, conversion plan, Medicare or Medicaid. You must have had continuous full medical insurance coverage for a minimum of 18 months with no lapses greater than 63 days.
Although the cost of HIPPA can be double or triple the amount of standard individual insurance plans, if you meet all of the eligibility requirements, it is a viable option for you if you are contending with a pre-existing condition. In order to provide proof of coverage as an eligibility requirement, you can request a certificate free of charge from your health insurance company. Creditable coverage may also be proven with pay stubs that show a deduction for your health insurance premium, EOBs (Explanation of Benefits), a termination notice from Medicare or Medicaid, and possibly even written verification from your doctor or former provider.
If you are planning on switching jobs and therefore insurance, it is a good idea to request the proof of coverage certificate from your insurance provider ahead of time to allow time to receive it. Remember, continuous coverage without a lapse beyond 63 days is essential. If you spend more than two months trying to prove you had insurance after your insurance ended, you are going to be in jeopardy of not meeting a main eligibility requirement.
Cover Florida Options And Limitations
Cover Florida is a state sponsored plan for people who have had no insurance for six months. Although it is not a major medical plan, it is a defined, limited benefits plan with guaranteed issue. This means that you cannot be denied coverage, although you may have to wait one year for your pre-existing condition to be covered. Although the plans vary somewhat with the different carriers, generally generic prescription drugs are covered and there are limited benefits for hospital stays and emergency room visits. Typically, the plan carries a high deductible but offers good benefits for preventative care.
Additional Options For Pre-Existing Conditions
There are several things to keep in mind when seeking health insurance while having a pre-existing condition. Although a pre-existing condition may not be covered, you can still obtain health insurance for your other health care needs. Exclusionary Riders vary, so be sure to read your policy and riders carefully. There are Permanent Riders that exist for the life of the policy and there are Temporary Riders that are usually valid for one or two years.
If you go one year without treatment for a pre-existing condition, you can call your insurance carrier and request the removal of a temporary rider that is two years long. The health insurance company is not obligated to grant your request, but they may do it as a courtesy. Keep in mind that treatment includes taking medication as well as seeing a doctor or taking related tests.
Another option you can consider is temporary health insurance, also known as Short Term health insurance. Although these plans are not long term, they do tend to be underwritten more liberally and therefore may be easier to obtain with a pre-existing condition.
It is important to choose a liberal carrier because if a company rejects your application for health insurance your chances of getting approved by another carrier will subsequently drop. For this reason, it is a good idea to speak to an independent agent who can assess your situation and direct you toward an insurance company that is a more likely candidate for you. To speak to an independent agent you can call the number above.
Compare Plans Available To You Now!
Whether you have a pre-existing condition or not, one of the most important tips to keep in mind when applying for FL health insurance is to be honest. Since insurance companies have a right to request medical records before paying a claim, lies can easily be uncovered and your policy may be rendered invalid as of its start date. By comparing various companies and plans you can find a health insurance policy that is best suited for your personal situation. To begin comparing quotes now, enter your zip code in the free health insurance quote finder above!