FAQs: Individual Insurance

With health coverage costs on the rise, many wonder how individual health insurance can be beneficial for their family. In various cases individual coverage has proven to be financially favorable to COBRA or higher employer plan premiums.

I am often asked what it takes to obtain coverage, and why individual health insurance should be considered in your selection process when researching coverage options.  Below are answers to some of the more frequently asked questions.

Am I required to medically qualify for individual coverage?

Yes. Current underwriting guidelines per carrier articulate that every applicant must be underwritten and approved for the individual policy that is applied for. Medical underwriting estimates an applicant’s health risk and ultimately determines if the applicant is eligible for coverage, as well as the final rate if coverage is approved. Once you are accepted, your coverage cannot be cancelled for any reason other than non-payment termination. On January 1, 2014, individuals will no longer be required to medically qualify for health insurance due to guaranteed issue.

I have a pre-existing condition. What are my options to obtain individual health insurance?

If you do not have the option for group coverage or have exhausted COBRA, you could be eligible for coverage through a High-Risk State Pool. These pools offer comprehensive benefits to individuals who are unable to medically qualify for coverage in the private market.

How will current stipulations and benefits change in 2014, and how will it affect me?

As a part of the Affordable Care Act (ACA or Health Care Reform), there are many variables that will be impacted when the Exchange plan options are made available. Common examples that will directly impact the individual market include guaranteed issue to all applicants, minimum essential health benefits required for all plans, and standardized premium adjustments based on elements such as age, gender, tobacco status, and geographical location. If you are currently covered under an individual policy that is non-grandfathered, you will be required to move to an ACA-compliant plan.

What is the process for obtaining individual health insurance?

Caravus is able to offer guidance and service to those interested in researching their coverage options. After contacting an Individual Market Consultant, we will gather additional details regarding your health needs and benefit desires, and put together a proposal for you to review. The options will be compared to your current benefits and premium (if applicable), as well as which plan best fits your coverage necessities. After discussing, you may submit an application to the chosen carrier to go through the underwriting process. Underwriting decisions can take up to 2-3 weeks. If approved, your policy will then be assigned an effective date dependent on your original request for coverage.

I only need coverage for a short amount of time. Can I still apply?

Yes. Multiple carriers offer short-term plans that range from a minimum of one month up to six months of coverage. These plans are affordable and ideal for healthy individuals so that there is no lapse between employer plans or while fulfilling waiting periods.

If you have questions about individual insurance, contact a Caravus Individual Market Consultant for more information.