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Individual Insurance policies and HIPPA
Sep 3, 2002

In one of your recent answers on HIPPA questions you stated "HIPPA also provides a means for someone to purchase an individual policy if he hasn't gone more than 63 days without coverage". Does this mean that during my 18 months of "temporary" COBRA coverage, I can buy an individual health insurance policy with no pre-existing conditions from any health insurance company (i.e., the company can not turn me down -and can not charge me a huge rate for such coverage - which is the same thing as turning me down).

Gary M. Kelly cbkelly1@aol.com

Response from Ms. Franzoi

This means that after COBRA expires, as long as you obtain coverage before 63 days has passed, an insurance carrier that offers individual policies will have to sell one to you. Although it might be at higher rates and HIPAA rates often range from 35% - 60% higher than standard rates. A HIPAA policy, even if it has a pre-existing condition clause, cannot impose more than a 12-month exclusion period and must recognize your period of coverage under other group plans such as your COBRA coverage. Therefore, if you apply for a policy, the insurer would have to sell you a HIPAA policy and recognize your COBRA coverage towards any pre-existing condition period they had. Since that period cannot exceed 12 months and you would've had COBRA for 18 months, there would be no pre-existing condition clause applied to you. Another option you might have at the end of COBRA is conversion. However, this would apply only if your health plan is an insured plan. You should contact the plan administrtator to find out if conversion is available, what type of coverage and the cost.



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