Guide to Guaranteed Issue Health Insurance
Guaranteed issue simply means that the health insurance policy will be issued regardless of your medical conditions. There is no underwriting and there are no medical questions on the application.
With traditional health insurance, there are a series of medical questions that you are asked prior to the issuance of a health insurance policy. They can deny coverage based on your answers. With most of our plans, your current or past medical conditions cannot be used to deny coverage.
mind, that even if a traditional health insurance plan accepts
you, they might not cover your pre-existing conditions. If you
have had 12 months of prior coverage without any breaks of more
than 63 days, the guaranteed issue plans will cover your prior
health conditions. You will get credit for the time you had coverage
if it is less than 12 months.
If you are reasonably healthy and your current medical conditions are well controlled, you could most likely qualify for a traditional health insurance plan and do not need to have a guaranteed issue plan. We have spoken to individuals who were declined by one carrier, yet we knew they would be accepted by another. If you call us, we have a fairly comprehensive knowledge of underwriting standards and will give you an assessment as to whether you need a guaranteed plan or not.
Your definition of healthy and the insurance company's definition might differ. If you had bypass surgery 10 years ago and now can run a marathon, you will still be uninsurable by traditional carriers. Although, we would be glad to issue you a policy.
If you are medically uninsurable, then you most certainly need a guaranteed issue plan and we will help you determine which plan best suits your needs and your budget.
Sometimes, a carrier is willing to issue a "regular" health insurance policy but will permanently exclude your pre-existing medical conditions. Depending on the nature of these exclusions, you still might want a guaranteed issue plan. After all, you do not want to get into a protracted legal battle because a carrier would not cover a heart attack, or cancer by claiming it was related to your "excluded" condition.
instances, a policy might be issued without exclusions, but the
premium is increased to an astronomical figure. Once again, a
guaranteed issue plan might be the best alternative.
COBRA is a continuation of your group health insurance plan. It generally lasts for 18 months. Sometimes COBRA is cost effective and sometimes it is not. In either instance, it will only last for a limited time period.
HIPAA plans are sometimes referred to as continuation plans. You must first use up your COBRA before you are eligible for a HIPAA plan.
HIPAA plans are very expensive and continue to go up a substantial amount each year. You can easily find yourself paying thousands per month. Our plans are an excellent alternative.
There are certain states that have "pools" for health insurance. Again, these plans are expensive and are rapidly disappearing as participants are moved off of them and on to Medicaid. The problem is, the income requirements for Medicaid are so low, very few of you will qualify.
COBRA, HIPAA and State Pools can be very expensive. Our guaranteed issue plans could lower your premium by thousands per year.
We do not sell discount plans. All of our plans are "real" health insurance and sold only by licensed health insurance agents.
more than one guaranteed issue health insurance plan with a variety
of coverage options. But, in all instances, there is a legitimate
insurance company behind it.
That is an excellent question with a somewhat complicated answer. However, I am going to try to give you a simplified version.
The indemnity plans we offer have either defined benefits or maximum annual payout for claims.
In the case of a defined benefit, the insurer knows what their maximum exposure is. If they pay $1,000 a day for a hospital, they know the limits of their liability. A traditional company has virtually unlimited liability. In the case of a serious illness, they can pay out millions in claims. Although, most claims are less than $10,000, they still impose strict underwriting standards.
All of these plans can get confusing.
An indemnity plan, defined benefit plan and mini-medical plan are all really the same thing. Mini-medical is a made up name for a plan that has less coverage than a major medical plan. There is no accepted universal definition. So, please be careful when someone says they have a "mini medical" plan.
We offer a number of indemnity/defined benefit plans with varying benefit levels. Again, I am not going to keep repeating the term "mini-medical", it is exactly the same thing as an indemnity plan or a defined benefit plan or a limited benefit plan.
A defined benefit plan is sometimes referred to as an indemnity plan. That means that it pays you (or the provider) a fixed amount (defined amount) for a medical expense.
For example, if the plan pays $1,000 a day for the hospital, that is the defined benefit. They do not care where you go, why, who you see, what they do to you or what it costs. They are telling in advance that they will pay exactly $1,000 a day for hospitalization.
You just have to keep in mind that a limited benefit, indemnity or mini medical plan is a health insurance plan with limited coverage. That does not mean that they will not provide adequate coverage for 99% of the population.
All of our plans offer you access to large national PPO networks. You will always be entitled to the network rate for all of your medical expenses. The network discounts are usable even after the plan benefits are used up. This alone can be a dramatic savings.
Some of our plans have an actual co-pay for office visits and some pay you or the provider a fixed dollar amount.
Only 7% of population spend 1 night in hospital and less than 1% spend a night in the hospital on two separate occasions. The average retail cost is $1371; with PPO network, the cost is $960. So, the limits of the mini-med or defined benefit/indemnity plan will meet the average person's needs.
A guaranteed issue health insurance plan might be the only coverage available to you. You should not go without any coverage at all if you can help it. Do not dismiss any of these plans without investigating them carefully.
I always recommend you calling me to discuss your situation. My number is 800-272-0512.
Yes, you can have a business billed for these plans and any of them can be offered as a voluntary or non-voluntary group plan.
With the new healthcare bill, two things will happen.
The first is that premiums for traditional major medical plans will go through the roof. This is all part of the concept of taking from those who have and giving it to those who do not have.
The second thing is that limited style benefit plans will not be HIPAA compliant. I do not care how many stickers people put on their websites. They will not be considered "credible coverage" and not count as having health insurance if you change plans.
By stacking, we simply mean purchasing more than one plan and combining their coverage.
Most of our plans cover maternity. The only requirement is that you are not pregnant when you obtain the insurance. There is no waiting period for the maternity benefits. We actually have one plan that will accept someone who is up to 8 weeks pregnant.
A critical illness plan pays you a lump sum amount in the event that you suffer a heart attack, life-threatening cancer, stroke, kidney failure as well as a number of other illnesses.
I recommend you give me a call. If you have a chance, look at the plan detail pages beforehand. Once you read through my web site, you will be armed with enough information for us to work together and figure out a strategy.
We can be reached Mon - Thurs from 9 AM to 8 PM EST and on Fridays until 6 PM. Leave a message if you cannot reach us. We generally get back to you in 24 hours or less. Or Click Here to send us an email
Call us at 800-272-0512 (9 AM to 9 PM EST)
This plans have a pre-existing conditions limitation. Pre-existing conditions are not covered until the policy has been in effect for more than 12 months. A pre-existing condition is any condition you have now or had within a 12 month period prior to the effective date of coverage for each covered person. If you have had prior credible coverage, up to 12 months can be substituted and pre-existing conditions may be covered immediately