If you are considering buying individual health insurance in Florida then it is important to start by acquainting yourself with Florida health insurance law.
As is the case in the majority of states, Florida gives limited guarantees to anybody who wants to buy individual health insurance and, despite the fact that your capacity to buy medical insurance will depend to some extent on your present state of health, there are certain situations in which health insurers in Florida have to offer to insure you.
In general, health insurance companies are permitted to ask questions concerning your past medical history and to refuse you cover if you have a current medical problem or have a history of particular conditions. More commonly however insurance companies will offer to cover you, though they will either exclude particular conditions from your plan or raise your premium and cover such conditions. In Florida however there is an exception to the rule in the case of a history of breast cancer where you have finished a course of breast cancer treatment at least two years before your present request for insurance. In this instance insurance companies are not permitted to refuse to cover you.
As long as you have been insured under group insurance for a period of at least three months and subsequently lose your cover then, in Florida, you can buy a conversion plan and an insurer are required to offer you the choice of at least two plans. Additionally, companies cannot require any new pre-existing condition exclusion. They can however enforce such an exclusion where you have not reached the end of any previously imposed qualifying period.
Where you are not able to qualify for a conversion plan but are however HIPAA eligible then an insurer may not refuse you cover and must offer you a choice of at least two plans. To be HIPAA eligible you must have had at least eighteen months of continuous and creditable coverage (the last day of which has to have been under a group health policy) and have used up any eligible COBRA or continuation coverage. Further, you must not presently have any health insurance (or your present group cover must be about to expire) and must not be eligible for another group policy or for either Medicaid or Medicare. An application for health insurance on the basis of HIPAA eligibility must be completed within 63 days of losing your previous cover.
When an insurance company or HMO can no longer offer cover, because they have for instance ceased trading or you have moved to a location outside of their service area, then other insurance companies have to offer to provide you with cover whatever your state of health.
Newborn children, adopted children and children who are placed for adoption must automatically be covered under the terms of a parent's individual insurance plan for a period of 31 day from the date on which the child is born, adopted or placed.
In Florida a child who is disabled will continue to enjoy the benefit of cover where dependent coverage has previously been in issue past the age at which cover would normally be ended, providing the child is not able to support himself (or herself) as a result of either physical or mental disability and is dependent on the policyholder for support.
The cover afforded by an individual health insurance plan in Florida will depend to a large degree on the particular plan which is purchased but it is a requirement of Florida law that all plans cover a number of benefits such as diabetes treatment, mammograms and childhood immunizations. The list of mandatory benefits is updated from time to time and an up-to-date list may be obtained from the Florida Department of Financial Services.
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