Health Insurance Approval

This health insurance is for the following 40 states only: AL, AZ, AR, CA, CO, CT, FL, GA, ID, IL, IN, IA, KS, LA, MD, MI, MN, MS, MO, NE, NV, NH, NJ, NM, NY, NC, OH, OK, OR, PA, SC, TN, TX, UT, VA, UT, VA, WA, WV, WI.

Good Health

You have to be in 'good health' to be accepted. Each insurance company has its rules as to what is 'good health'. It may not be your definition and may not agree with your doctor's opinion.

You also have to be within the insurance company's height-weight table (example of typical table ranges).

If the answers to all health questions is 'no', that's good health. If all 'yes' answers are for health conditions that cost little to treat or are so long ago that the risk of recurrence is considered small, that is 'good health'.

If the premium can be raised enough to cover the cost of the pre-existing condition, or if the insurance company can exclude coverage for that particular pre-existing condition, that's also good enough to be 'good health'.

Generally, if you have current pre-existing conditions whose treatment is or could be very expensive, you should apply for a government program.

Outside of coverage provided by an employer, health insurance is priced to cover medical conditions that may arise in the future, not those that exist now.

Types of Health Insurance

While there may be other considerations, there are basically two types of health insurance based upon who is buying it. The two types are those purchased by an employer and those purchased by an individual.

An individual can add family members to be covered but it is still an "individual" purchase and so is called "individual health insurance" even though more than one person is covered by the plan. An employee can include family members to be covered by an employer plan but it is still "employer coverage".

An employer with 50 or less employees cannot be turned down but, in most states, individuals and employers with more than 50 employees can be turned down.

Getting Accepted or Being Turned Down

There is no point to filling out application forms if you only get declined. According to the insurer's rules, your application can be turned down in most states because most states do not have mandatory issue of individual health insurance.

If you are on medication or have pre-existing conditions, please look at Reasons for Being Declined for more information.

Individual health insurance is not priced so as to take over the risk or expense of significant pre-existing conditions or expensive medication.

Therefore, if there are significant pre-existing conditions or expenses, insurers selling individual health insurance will either decline the application, or exclude the pre-existing expense, or charge more (a "rateup") for that individual compared to those with no pre-existing expenses.

Guaranteed Coverage

Many states have 'High Risk Pools' that extend coverage to all applicants who have been declined for individual health insurance.

Even though the rates may be subsidized, it will still cost more than comparable coverage from an insurance company issuing individual coverage.

The 1996 federal law known as HIPAA mandates that health insurance will be available to individuals who have exhausted eligibilty for prior group coverage and its extensions under COBRA, if application is made within 63 days of loss of coverage.

However, because HIPAA does not limit the premium charges to be the same as for applicants who qualify medically, the rates for mandatory issue is very expensive. Many states have replaced the HIPAA entitlement with eligibility for its High Risk Pool.

There are also limited benefit plans from private insurance companies which are issued to all applicants, but they pay only fixed amounts for specific expenses.