Individual Health Insurance: Your Rights and Privileges

If the outlined provisions of your health insurance policies of past and present reside somewhere in the closet, you’re not alone. Packed full of industry jargon, who wants to take the time to read the rights and privileges of their health insurance policy?

As unappealing as your policy information may seem, it’s important to understand that certain state rights and privileges come with every health insurance policy—and when you understand those privileges, you can make better informed decisions about your health and your health care!

Getting Started

When it comes to understanding the facets of your health insurance policy it’s important to recognize that each state has its own set of rules and guidelines. For more detailed, state-specific information about health insurance in your state, contact your local Division of Insurance or visit them on the Web.

Your Protections

While some guidelines differ from state to state, many consumer privileges remain the same across the country.

Nearly all states have mandated insurance policies to be guaranteed renewable, which means that your health insurance cannot be cancelled if you get sick. In fact, under guaranteed renewability, an insurer can only drop you from a policy if you stop paying your premiums, engage in fraudulent behavior or move outside of the specified coverage area.

In addition to the swell in guaranteed renewability, many states are mandating that insurance companies cover certain benefits such as screening for breast, cervical and prostate cancers—making it easier than ever before for consumers to get the care they need.

And, while your health insurance options may be some what reliant on your health status (your quality of health, including pre-existing and/or chronic conditions), most states are now limiting pre-existing condition periods, which means that coverage for your pre-existing conditions cannot be drawn out for longer than one year.

Strides in State-Sponsored Coverage

In addition to guaranteed renewability and limitations on pre-existing condition exclusions, many states have taken great strides to increase insurability for their residents.

COBRA, or state-continued coverage, may be available to you if you leave your job, or if you’re waiting for a new health insurance policy to begin. If you qualify for COBRA, you would be allowed to remain on your previous employer’s group policy for a pre-determined length of time.

Many states are also expanding the eligibility requirements for state-sponsored health insurance. If you’ve been turned down for individual health insurance due to a pre-existing or chronic condition, you may be eligible for health insurance under your state’s Medicaid program.

Medicaid coverage may also be available for those that earn low wages, families with uninsured children, pregnant women and disabled individuals. Medicaid also sponsors many children’s programs, as well as a variety of health screenings and programs for women.

Know Your Rights

When you know the rights, privileges and limitations of health insurance, you can make better informed decisions when comparing health insurance quotes and choosing a policy.

So dig that policy information out of the closet and take a look! And for more information on health insurance policies and mandated benefits, or to find answers to your health insurance questions, visit your state's Division of Insurance online!

About InsureMe

Megan L. Mahan is a copywriter and insurance information expert with InsureMe in Englewood, Colorado. InsureMe links agents nationwide with consumers shopping for insurance. Specializing in auto, home, life, long-term care and health insurance quotes, the InsureMe network provides thousands of agents with insurance leads every year. For more information, visit InsureMe.com.

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