You Can Not Be Turned Down For Health Insurance

Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services. In most states, guaranteed issue doesn’t limit what you can be charged when you enroll in a plan.

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Nevada Insurance Enrollment logo - Nevada State outline divided into four colors of dark blue, light blue, orange and yellow

The Affordable Care Act and Guaranteed Issue Health Insurance

Prior to 2014, individual market health insurance companies determined an applicant’s eligibility largely based on their medical history. Applicants could be denied coverage, either altogether or for certain conditions, if the health insurance company decided that they were more likely to use their coverage than the average member.

In other words, the individual market health insurance was not guaranteed issue. Many pre-existing conditions were an automatic decline, and that person could not ever get coverage through that insurance company. The only exception was through an employer, either a small or large group of employees. If the employer offered the coverage, the employee and family could get covered.​

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This changed in 2014 when most of the Affordable Care Act’s provisions took effect. The ACA required that all individual market major medical plans be guaranteed issue, meaning that they could not turn applicants away based on any factors including pre-existing medical conditions. You were no longer pushed into a corner to try and find an employer that offered group coverage.

To ensure individuals and families that did not have employer provided health care wouldn’t simply wait until they needed coverage to purchase coverage, the enrollment period was limited to a single “open enrollment period”. To make provision for those who had a “life change” (marriage, birth of baby, move, etc.) that affected their insurance needs, there were special enrollment periods instituted.​

 

Nevada Insurance Enrollment Is Here to Help

Health insurance is a necessity; for most people, the medical bills that result from a single injury or illness could wipe out their savings and seriously jeopardize their financial future. At Nevada Insurance Enrollment, our health insurance agents are here to help you get the coverage you need, regardless of your medical history.

Does Health Insurance Cover Drug Rehab?

Does Health Insurance Cover Drug Rehab?

Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.

Does Health Insurance Cover Sex Change?

Does Health Insurance Cover Sex Change?

Gender reassignment surgery in order to be considered medically necessary, certain criteria must be met, such as if a qualified mental healthcare professional provides a referral and medical or mental health concerns are present.

Does Health Insurance Cover Hair Loss?

Does Health Insurance Cover Hair Loss?

If you are experiencing hair loss due to an underlying medical condition, then there is a good chance that your health insurance will cover treatment for the condition, either completely or at least a portion of the cost. To be sure, you’ll want to check your “Agreement of Coverage” document.

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