Guaranteed-Issue Health Insurance

• People with pre-existing medical conditions can still obtain individual health insurance. Five states--Maine, Massachusetts, New Jersey, New York and Vermont--have passed laws that mandate insurance companies to accept people for individual health insurance policies, regardless of age or health risk. You must be a resident of one of these states to be eligible to apply. There are other states (Idaho, Michigan, Ohio, Oregon, Utah, West Virginia and Washington State) that mandate limited coverage for individuals that meet certain criteria or do not qualify for other coverage. You can contact your state insurance commission to find out specific eligibility requirements.
  
  

Affordable Care Act

• The Affordable Care Act was signed into law in March 2010. Many people assumed that the provisions of this act would immediately go into effect. But most provisions do not become law until 2014. As a result, the Department of Health and Human Services (HHS) started offering transitional health insurance plans on July 1, 2010. By going to the website www.healthcare.gov and answering a few short questions, you can find out what options are available for heath insurance coverage in your state.
  
  

High-Risk Insurance Pool

• In most states that do not offer guaranteed-issue coverage, a high-risk insurance pool is available. This option can be quite expensive, but for many people it may be their only option. High-risk pools may offer limited coverage or may not cover items like prescription drugs until a deductible is met. Other states offer several options for high-risk pool coverage, including plans that meet the qualifications for a Health Savings Account, which could offer some tax benefits to you. Consult with your accountant to find out if this would benefit you.
  
  

Elimination Period vs. Exclusions

• Depending on how long you've gone without insurance, you may have to go through an elimination period. Most insurers will have an elimination period for pre-existing conditions if you have been without insurance for at least 61 days. The elimination period varies by state, but most states limit the time to 12 to 24 months. During the elimination period, the insurance company will not pay for any treatment related to a pre-existing condition, including prescription drugs. When you apply for insurance, you will have to furnish a certificate of creditable coverage from your prior carrier to prove that you had health insurance in place for the time you claim to have been insured.
  
  If an insurance company chooses to exclude coverage for a condition, they will not cover any treatment related to the condition, even after an elimination period. Group insurance policies cannot exclude conditions on an individual basis.
  
  

Considerations

• It's important to evaluate all of your options when it comes to health insurance. If you are unable to obtain standard individual health insurance, or the cost of the high-risk insurance pool is too high, you can still obtain group coverage through an employer who offers health insurance. Be aware that you may still have to go through an elimination period if you've been uninsured.