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Guarantee Issue

Probably the most important item regarding health care reform and health insurance exchanges is the concept of guaranteed issue health plans. This means that coverage will be available to anyone regardless of their current health. Prior to this, anyone with conditions ranging from high blood pressure to cancer could be denied health insurance coverage even if they had maintained continuous coverage. Insurance companies would require that a medical questionnaire be completed and considered in order to verify how much of a financial risk members could be. Based on this, many found themselves being denied and faced with the prospect of going without coverage.

While a few options were available to such individuals, such as the Pre-Existing Condition Insurance Plan or the Major Risk Medical Insurance Plan, many found they did not meet the necessary criteria or could not afford the premiums of these plans. The Affordable Care Act brought forth a new concept to prevent insurers from denying health coverage to anyone. Since only six states out of fifty offered guaranteed coverage, this means that millions will now be able to procure health insurance coverage beginning January 1, 2014.

Timeline of Guarantee Issue Health Coverage:

  • September 23, 2010 – Insurers can no longer deny children health insurance coverage
  • January 1, 2014 – Insurers can no longer deny coverage to adults with pre-existing conditions

The guarantee issue provision is intended to insure those who need it most. However, it also serves as a means of bringing more individuals into the health insurance risk pool, allowing insurers to cover medical claims without becoming insolvent.With tens of millions of currently uninsured or underinsured individuals, the concept of guaranteed health coverage is expected to make quite an impact on these numbers. Add to this the number of individual on risk pool or Major Risk health plans (click to see site), most of which place annual and lifetime limits on services, the allure of health plans within the exchange should only grow exponentially.

Health Exchange Quote Insurance Agency can help you determine which plan will best suit your needs, regardless of your current health issues.

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Laguna Niguel, CA 92677

Telephone: (800) 366 2751


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