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GUARANTEED ISSUE HIPAA COVERAGE

The Health Insurance Portability and Accountability Act (HIPAA) was passed into law in 1996.  This extensive, complex law has many regulations, some of which are just now becoming effective.  One of it's primary objectives was the portability of health insurance for those changing jobs and the assurance that everyone would have certain protections regarding their health insurance coverage; i.e. particularly relating to coverage for pre-existing conditions.  HIPAA established eligibility requirements for individuals to purchase individual health insurance on a guaranteed issue basis and required insurance carriers to issue such policies to HIPAA Eligible Individuals. While seeming straightforward enough, there are plenty of loopholes that will create problems for many individuals.  First, you must determine if you ARE a HIPAA Eligible Individual.

how do I know if i'm eligible to purchase guaranteed issue hipaa coverage?

Your eligibility to have HIPAA guarantee you the right to purchase individual health insurance coverage, depends on your ability to meet ALL of the following requirements:

• You have at least 18 months of creditable coverage without a significant break in coverage; i.e. more than 63 days without any coverage

• Your most recent coverage MUST have been through a HIPAA compliant group health plan (through your, or a family member's employer, or union).  NOTE: Some group health plans are not required to comply with HIPAA requirements, such as Churches and State, or Local government employers.

• You are not eligible for Medicare, or Medicaid

• You do not have other medical insurance

• You did not lose your insurance for not paying the premiums, or for committing fraud, and

• You accepted and used up ALL your COBRA continuation coverage, or similar State continuation coverage, if it was available to you.

If you meet ALL the above eligibility requirements and feel you will be unable to secure  coverage without significant limitations due to pre-existing medical conditions, contact us.  We'll be happy to review your situation and evaluate other possible coverage options, as well as provide you HIPAA compliant quotes.

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