Resources
Overview on HIPAA Guaranteed Issue Health Insurance
What is a HIPAA?
HIPAA stands for the Health Insurance Portability and Accountability Act, which is a law mandating that anyone belonging to a group health insurance plan must be allowed to purchase health insurance within a specific period of time based on when the previous coverage is lost. This law protects employees, especially those with long term health conditions who may not qualify for other insurance coverage under a new insurance plan due to pre-existing medical conditions.
Who qualifies for this insurance?
Those who are exhausting COBRA/Cal-COBRA programs or are losing group health coverage with no employer continuation offer.
Why would I want to select this option?
If you qualify and are not medically able to obtain a private underwritten health insurance plan, you may be eligible to apply for a guaranteed issue health plan (HIPAA Plan).
What are the rules in order to purchase the guaranteed-issue health coverage?
HIPAA regulations allow you to purchase guaranteed-issue health coverage under the following rules:
1. COBRA or Cal-COBRA benefits must he exhausted or not offered;
2. You must apply for HIPAA coverage within 63 days of termination of COBRA, Cal-COBRA or employment if no COBRA offered;
3. You must have been covered for 18 months continuously prior to HIPAA effective date with the most recent coverage being employer-sponsored group health insurance with no gaps greater than 63 days between any prior coverage;
4. Must not be enrolled in nor eligible for Medicare Part A or B, Medicaid or MediCal or covered by another group health insurance plan.
