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What Does Guaranteed Issue Health Insurance Mean?

by | Oct 13, 2024 | Health Insurance

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You Can Not Be Turned Down For Health Insurance

Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services. In most states, guaranteed issue doesn’t limit what you can be charged when you enroll in a plan.

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What Does Guaranteed Issue Health Insurance Mean?

The Affordable Care Act and Guaranteed Issue Health Insurance

Prior to 2014, individual market health insurance companies determined an applicant’s eligibility largely based on their medical history. Applicants could be denied coverage, either altogether or for certain conditions, if the health insurance company decided that they were more likely to use their coverage than the average member.

In other words, the individual market health insurance was not guaranteed issue. Many pre-existing conditions were an automatic decline, and that person could not ever get coverage through that insurance company. The only exception was through an employer, either a small or large group of employees. If the employer offered the coverage, the employee and family could get covered.​

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This changed in 2014 when most of the Affordable Care Act’s provisions took effect. The ACA required that all individual market major medical plans be guaranteed issue, meaning that they could not turn applicants away based on any factors including pre-existing medical conditions. You were no longer pushed into a corner to try and find an employer that offered group coverage.

To ensure individuals and families that did not have employer provided health care wouldn’t simply wait until they needed coverage to purchase coverage, the enrollment period was limited to a single “open enrollment period”. To make provision for those who had a “life change” (marriage, birth of baby, move, etc.) that affected their insurance needs, there were special enrollment periods instituted.​

 

Nevada Insurance Enrollment Is Here to Help

Health insurance is a necessity; for most people, the medical bills that result from a single injury or illness could wipe out their savings and seriously jeopardize their financial future. At Nevada Insurance Enrollment, our health insurance agents are here to help you get the coverage you need, regardless of your medical history.

What is Co-Insurance?

What is Co-Insurance?

Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.

Is Health Insurance Worth The Cost?

Is Health Insurance Worth The Cost?

If you experience a more extensive medical emergency and require hospitalization, hospital bills may quickly become a burden. A three-day stay, for example, could set you back about $60,000 depending on what tests are ordered and what happens during your stay.

Surrogacy Laws in Nevada

Surrogacy Laws in Nevada

Generally speaking, the intended parents are responsible for covering pregnancy-related expenses, including complications that may arise over the course of the pregnancy and delivery. The standard way to control health care costs is to purchase health insurance for the woman acting as the gestational surrogate.

 

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#4) Insurance Blog

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By page visits (this month)

 

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog Posts

#5) Request a Quote

How Much Will I Have to Pay For an MRI?

While MRIs are generally covered by health insurance, it is left to the discretion of your health insurance company to decide whether the test is medically necessary. If your provider determines that it is not, then you may pay for the procedure out-of-pocket.

Does Health Insurance Cover Hair Loss?

If you are experiencing hair loss due to an underlying medical condition, then there is a good chance that your health insurance will cover treatment for the condition, either completely or at least a portion of the cost. To be sure, you’ll want to check your “Agreement of Coverage” document.

Health Advice From Centenarians

Gardening has been shown to positively impact our moods, reduce stress and alleviate symptoms of anxiety and depression. However, studies have shown that the benefits of this hobby may extend even beyond promoting a sense of contentment and well-being.

Signs You Should Go See Your Doctor

Sometimes, deciding whether to see a doctor is a gray area, but it’s better to err on the side of caution. If you are experiencing a serious injury or illness, it is easy to justify making a call to your local medical office. However, it is important to remember that early detection generally leads to better outcomes.

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