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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.
Finding a health insurance plan that covers your preferred healthcare providers and necessary medications can be a challenge, especially if you split your time between two states or travel frequently.
The way health insurance is being marketed may give you the wrong impression that Nevada Health Link is the ONLY place to buy health insurance these days, but that is NOT the case. You can continue to buy your health insurance from the same agents and agencies you’ve always bought your health insurance from.
On the employer’s end, providing health insurance can be costly and complicated. However, it can also be a reliable way to bring in new hires, improve productivity and boost morale and job satisfaction. Small businesses that want to provide this benefit have options that let them do so affordably.
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Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.
Like major medical health insurance plans, catastrophic health insurance covers the 10 essential health benefits outlined in the Affordable Care Act. However, if you have this type of plan, your out-of-pocket costs for services are considerably higher than with regular health insurance.
A prescription deductible is different and separate from the medical deductible, unless otherwise stated. One deductible is for medical, ie: hospitalization, doctors, etc., and the other deductible is for filling your prescriptions.
Gender reassignment surgery in order to be considered medically necessary, certain criteria must be met, such as if a qualified mental healthcare professional provides a referral and medical or mental health concerns are present.