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 Purchasing An Individual Health Insurance Policy In The State Of Florida

Purchasing An Individual Health Insurance Policy In The State Of Florida

 


Florida, like the majority of states, grants limited guarantees to anyone who wishes to buy individual health insurance and, whilst your capacity to buy health insurance will depend to a certain extent upon your current state of health, there are situations where health insurers in Florida have to offer you insurance.

Usually, health insurance companies are permitted to ask questions about your past medical history and to refuse you cover if you are currently suffering from a medical problem or have a poor medical history. More usually however insurance companies will insure you, although they will either exclude specific conditions from your insurance policy or raise your premium and permit cover for such conditions. In Florida however there is an exception to this rule in the case of a history of breast cancer where you have had a course of treatment for the condition a minimum of two years prior to your current request for insurance. In this instance insurance companies are not permitted to refuse to cover you.

When you have been covered by a group insurance plan for at least three months and then lose your cover then, according to Florida law, you can purchase a conversion policy and an insurer have to offer you the choice of a minimum of two policies. Also, companies cannot impose any new pre-existing condition exclusion. They can however enforce an exclusion clause if you have not completed any previously imposed qualifying period.

When you cannot meet the qualifications for a conversion plan but are nonetheless HIPAA eligible then once again an insurer may not deny to insure you and must once again offer you a choice of a minimum of two policies. HIPAA eligibility requires that have had a minimum of 18 months of creditable continuous coverage (the final day of which must have been under a group health policy) and have used up any COBRA or continuation coverage for which you were eligible. Further, you cannot currently have any health insurance (or your current group plan cover must be about to expire) and cannot be eligible for another group insurance policy or for either Medicaid or Medicare. Finally, an application for health insurance on the basis of HIPAA eligibility must be submitted within 63 days of losing your prior cover.

Where an insurer or HMO is no longer able to offer cover, because they have for example become insolvent or you have moved outside of their service area, then other insurance companies must offer to provide you with insurance cover regardless of your state of health.

Newborn children, newly adopted children and children who are placed for adoption must be covered under a parent's individual insurance policy for 31 day from the date of birth, adoption or placement.

Under Florida law a disabled child is to continue to enjoy cover when dependent coverage has been in issue beyond the age when cover would usually be terminated, as long as the child is unable to support himself (or herself) because of either physical or mental disability and is dependent upon the policyholder for support.

In Florida the cover afforded by an individual health insurance policy will be largely dependent upon the policy which is bought but it is a requirement of Florida law that all policies cover certain benefits such as mammograms, childhood immunizations and diabetes treatment. The full list of required benefits is updated occasionally and a current list may be obtained from the Florida Department of Financial Services.

 

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