What Factors Affect Rhode Island Individual Health Insurance?
When learning about individual health insurance, several factors must be considered before choosing a policy. There are differences between HMO and PPO type plans, the level of out of pocket costs (annual deductibles and co-pays), and the financial strength of the insurance company to evaluate. However, possibly the most important criterion to impact your coverage is the health insurance company's practices on the medical underwriting of applicants for new policies.
The practice of medical underwriting for individual insurance policies is very different from what happens with group insurance programs. Per the law, in a group health insurance plan, there can be no discrimination in coverage levels applied to any individual in the group based the person's health status. In contrast, for individual health insurance plans, discrimination based on an individual's health status is actively performed now and is generally legal! If any person who applies for an individual insurance policy has a disability or existing medical condition, the insurance company is free to deny insurance to the applicant or to offer only insurance that excludes the medical condition or disability.
This practice results from the medical underwriting of each new health insurance policy which applies to the majority of new policies purchased by consumers in the individual insurance marketplace. What the concept of medical underwriting actually means is that the insurance company is analyzing the potential financial risk under the proposed policy based on the specific health status of the individual. When thinking about new health insurance, consumers should always call the medical underwriting staff of the insurance company early in the process to see how they deal with specific health issues.