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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.
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.
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.
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.
During the Medicare Annual Election Period (AEP), which is from October 15th through December 7th each year, many people may ask the question, “Do I want a Medicare Advantage Plan or a Medicare Supplement Plan (Medigap)?”
The Affordable Care Act / Obamacare, put specific enrollment periods in place to prevent people from only enrolling in health insurance when they were sick or needed surgery.
Even if you live in a state that requires health insurance coverage for fertility treatments, there may be certain requirements that you have to meet to have services covered. For example, if you have unexplained infertility, you might only qualify for in vitro fertilization after a period of time or a specified number of in-vitro cycles.
By page visits (this month)
By page visits (this month)
Your out-of-pocket maximum is the most you’ll have to pay for covered services in a policy period (one year), each January 1st it starts over again, and that includes cost of medications too. After you reach this amount, your health insurance plan will pay 100%.
Breast reduction surgery is a common procedure that involves removing fat, tissue and skin to reduce the overall breast size. Depending on your reasons for seeking this procedure, it can have a big impact on your comfort, health and quality of life.
As intimidating as gum disease and its associated conditions sound, the good news is that diligently brushing and flossing daily, along with regular visits to the dentist, is generally enough to keep the bad bacteria under control.
If you experience a major life change, then such a change is often considered a qualifying life event. Such life events affect your existing health insurance coverage and can make you eligible to change your coverage during the special enrollment period.