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Restrictions on conversion policies
Aug 8, 2000

Hello, I have two questions regarding converting to an individual policy when my COBRA runs out: 1. Can the insurer deny coverage under a conversion policy if the applicant qualifies for Medi-Cal (Medicaid in CA) and/or Medicare? 2. Can the insurer apply limitations to the conversion policy for people with a pre-existing condition (specifically, limits on payments for prescription drugs) that they do not apply to their other policy holders? To put it another way, does the insurer have to offer the very same individual policies to a sick person who is converting from COBRA as they do to well people? Thanks

Response from Ms. Franzoi

1. No.

2. Conversion policies are generally the same whether you are healthy or have an illness. However, conversion policies typically have limits on the amount of benefits payable for medical expenses and prescription drugs.

Lynn L. Franzoi



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