Definition Monday: Guaranteed Issue

The wikipedia and basic definition is this:

Guaranteed issue is a term used in health insurance to describe a situation where a policy is offered to any eligible applicant without regard to health status.

So, let’s take a few examples that apply currently:

– If you work for an employer that offers a group health insurance plan, you have guaranteed issue coverage.

– If you are self employed and getting coverage in the individual market for whatever reason (unemployed), there is guaranteed issue coverage, but not for a Major Medical plan.  You will pay more for this type of coverage and you will pay more for your health insurance.

One thing that changed in September of 2010 is that children 18 and younger are eligible for guaranteed issue coverage.  So, for example, if you have a child with Diabetes, which would normally be uninsurable under a major medical plan, but you and your spouse are healthy, your would be able to get a major medical plan for your family.  Taking it a step further, your child would not affect your health insurance premium because they are guaranteed issue.

Lastly, under the Patient Protection and Affordable Care Act (PPACA), everyone will have Guaranteed Issue coverage available in either the Bronze, Silver, Gold or Platinum policies.  So, if you currently have an “uninsurable” medical condition, you will have coverage at the same cost as someone else in your area with the same age.

More info to come:  Next I will define pre-existing condition and how it relates to Guaranteed Issue and PPACA.



Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s