With the initial implentation of health care reform, individual major medical insurance from private carriers is not guaranteed issue for adults. For children under the age of 19, it is guarantee issue if they apply with a parent or guardian who qualifies for coverage. Some states have worked with insurance companies to offer child only policies during specified open enrollment periods.
One key issue to keep in mind is that guaranteed issue is NOT guaranteed price. If the child has medical issues the company will increase the premium to compensate for the perceived risk. However, there are options. Two options are available to parents looking for guaranteed issue plans for themselves or for children only. They are:
- State Risk Pool
- Federal Risk Pool
To locate your State risk pool option, search for “State health insurance risk pool for XYZ”. You can locate information on the Federal Risk pool here.
Assuming no changes in Patient Protection and Affordable Care Act, guarantee issue plans at fixed rates will become available in 2014.