Guaranteed Issue Health Insurance
What can you do if you don’t qualify for the health insurance available through your employer? For many people who have some kind of pre-existing medical condition, this presents a real dilemma. Guaranteed Issue Health insurance, also known as GIH insurance, is an option if you are refused coverage in some kind of standard, more affordable healthcare plan.
Guaranteed issue health insurance plans evolved in the Seventies, when the huge insurance conglomerates began denying coverage for people with pre-existing conditions. The big companies used this tactic as a way to limit their payouts for healthcare costs.
But if you were someone who overcame an illness and then went back to a normal, productive life—with no social security benefits or Medicaid to see you through—then you were between a rock and a hard place. The first GIH insurance plans were offered by a few different states so that people could purchase private health insurance plans. Their biggest drawbacks were the high cost of premiums and the limitations of coverage.
Today there are many private companies that offer guaranteed issue health insurance. While prices are still higher than you will find with an employer-sponsored group health insurance plan, they are more affordable now than they were thirty years ago. And you can find a plan tailored to your individual health history and your current needs.
If you have been diagnosed with diabetes, cancer, heart disease, depression, or other illnesses, then you fall into this category. Consider some of these scenarios:
• You are working and you have health insurance. At your job you are diagnosed with diabetes, but you successfully manage your illness and continue with your job. When you change jobs, however, you discover that you do not qualify for coverage under your new employer’s healthcare plan.
• You are a married female who has been on her husband’s health insurance and you have been treated successfully for breast cancer. Five years later, you and your husband divorce and you move on in your life to a new career. However, you are unable to purchase health insurance.
• One of the above situations applies to you, except you are able to sign up for health insurance—but there is a one- or two-year waiting period until your coverage begins.
Guaranteed issue health insurance plans will provide you with insurance, but they will specifically exclude your pre-existing condition until the policy has been in effect for at least twelve months. Your policy will, however, cover costs that do not relate to your pre-existing condition for:
• Routine office visits
• Dental coverage
• Prescription coverage
• Outpatient surgery
• Inpatient hospitalizations
• Maternity coverage
• Lab work
• Accidents
In fact, if you sit down with the right insurance broker, you can get a policy written to fit just about any situation. And if you’ve been hit by a major illness, you undoubtedly realize just how important it is to have health insurance coverage for “the rest” of your body!
Most guaranteed issue health insurance plans operate like PPO plans. That means the plan will provide you with a list of providers. If you want to see a doctor, go to a lab, or have some other kind of medical service, you must choose someone from that list.
The big difference is the limitations on your use of the plan. For example, you might be limited to a set number of office visits per year or only so many x-rays. Some plans are issued as co-pay plans—you pay a percentage of each medical expense. Other plans are written as deductible plans—the plan won’t pay anything until you have spent a predetermined amount from your own pocket. And in many cases, you can use the guaranteed issue health insurance as a transitional plan, meaning that if you maintain coverage long enough without incident you will once again qualify for a standard group health insurance plan.
