"Rules of the game" concerning buying an Individual or Family Health Insurance Policy

Health Insurance rates have risen so drastically in the last few years. Also, the amount you have to pay on out of pocket before the policy will pay 100% has risen to unbelievable levels. All of these changes are so bad for those insureds that have to buy individual and family health insurance that I long for the "Good Ole Days" when a family health policy was a car payment and not 2 house payments per month! Yes, I feel like someone has broken into the United States and stole what we once had. Sadly, I think nothing is going to change to our present system in the immediate future. Yet, I wanted to address two situations I am seeing that you need to know the "rules of the game" concerning buying an individual or family health insurance policy.

The Clock is Ticking

The first thing you need to know is that the clock is ticking if you want to buy a health insurance policy to replace the one you lost. The new rules since 2010 are that you cannot have a break in health insurance coverage greater than 60 days if you want to have a policy that cannot exclude coverage for pre-existing conditions. 60 days is just two short months and there is no mercy on the part of the health insurance companies if you miss the deadline. If you try to enroll in a policy you will have to produce a letter as proof that you lost health insurance coverage in the last 60 days. If it has been just a day over the limit, you have to wait until the annual open enrollment period to get your health insurance back. The annual enrollment starts in November each year. Folks, don’t realize that you sign up for coverage starting November 1 but that policy does not start covering you until January 1 of the upcoming year!

Losing Health Insurance Due to Divorce

The last thing you need to know on the new rules of healthcare is that Divorce can be very detrimental to your choices of Doctors and Hospitals. I receive calls every week from people that are losing their health insurance due to a Divorce. What was not explained to them was that much of today’s individual and family health insurance plans are from policies that have much fewer choices of Doctors and Hospitals than the Group Health Insurance Policy that had when they were married. I had a call last week from a client in an area of our state where HMO Network plans dominate all of the choices for policies you can purchase. The client is facing losing her Specialist Physicians she must have because the HMO plans available to her in the County she resides are NOT "In Network" with her Doctors.

The Yellow Flashing Caution Light

So much more has to go into your planning for health insurance if you do not have access to a Group Health Policy from your Employer or your Spouse’s Employer. The Yellow Flashing Caution Light should be the picture that you see in your mind if you have to leave an Employer Plan so please take heed to these new rules we are all forced to deal with.