Moving from an Individual Health Plan to Another Individual Health Plan
I have had at least 12 months of health insurance coverage without a gap lasting 63 days or more (a significant gap in coverage):
Can a plan refuse to enroll me just because I am sick?
Yes, but . . . There are no federal regulations that prevent individual health plans from denying coverage for health reasons. Nevertheless, some states do not allow insurers to deny health coverage based on health status. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
Can a plan charge me more based on my health?
Yes, but . . . The federal government does not regulate insurance premiums in the individual market. On the other hand, some states do not allow insurers to charge higher premiums based on health status. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
Can a plan refuse to cover my illness for a period of time just because my illness was preexisting?
Yes, but . . . There are no federal restrictions on how long an individual health plan may refuse to cover an illness you had before joining. However, some states do have restrictions. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
I have had fewer than 12 months of health insurance coverage:
Can a plan refuse to enroll me just because I am sick?
Yes, but . . . There are no federal regulations that prevent individual health plans from denying coverage for health reasons. Nevertheless, some states do not allow insurers to deny health coverage based on health status. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
Can a plan charge me more based on my health?
Yes, but . . . The federal government does not regulate insurance premiums in the individual market. On the other hand, some states do not allow insurers to charge higher premiums based on health status. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
Can a plan refuse to cover my illness for a period of time just because my illness was preexisting?
Yes, but . . . There are no federal restrictions on how long an individual health plan may refuse to cover an illness you had before joining. However, some states do have restrictions. Contact your state insurance department for more information. You can find contact information at http://www.naic.org/state_web_map.htm.
[Return to chart]
