Qualify 1

 

 

 

 

 

Which Health Plans Do I Qualify For?


Do you, your spouse or any one to be insured have any pre-existing condition or on any medications?

(Please note that if you or your spouse are currently pregnant, you will not qualify for any individual plans.)

 

Yes                                      No

 

























 
Un-Insured Individuals and the Patient Protection and Affordability  


Health Insurance mandates in the U.S. have changed due to the “Patient Protection and Affordability Act” passed on March 23rd of 2010. This new law has a number of positive changes for the uninsured, insured, and Medicare recipients. For the uninsured, the government has initiated a Pre-existing Condition Insurance Policy (www.PCIP.gov) for those that cannot receive insurance due to a previous illness. These policies are issued to persons who have not had insurance in the past six months and who are uninsurable. An uninsurable person would be one that has been turned down to purchase major medical coverage after being diagnosed with a condition such as cancer, heart or liver disease, diabetes, bi-polar illness, HIV, stroke, etc. Usually, conditions such as high blood pressure, high cholesterol, smoking and abnormal weight gain, excluding obesity, are rated conditions and are accepted by the major medical companies at an additional cost or waiver to the consumer.

For some uninsurable persons, the government’s PCIP is not affordable and they do not qualify for Medicare or Medicaid. For those persons, we have “Limited Benefit Plans” that are guarantee issue and will give much of the needed care to reduce catastrophic expenses when confronted with an illness. These policies participate in major PPO networks and many offer doctor’s office visits for a set fee of $50 or less; provide scheduled dollar allowances for medical expenses in such areas as diagnostic care, hospital confinements, surgeons’ and anesthesiologists’ benefits. Usually, with some exceptions to generic drugs, brand named pharmaceuticals are provided at the PPO network’s pre-negotiated rates.


Insured Individuals and the “Patient Protection and Affordability Act”


For those persons that are insured, the government has added four popular new mandates to improve and stabilize insurability. These mandates include grown up children of the insured being able to stay on their parent’s health policy until age 26; children with pre-existing conditions under age 19 can’t be turned down for health coverage due to a pre-existing condition; eliminating life time maximum coverage, which was typically $5 million and would deplete on the sickest of the sick; and providing free routine annual physicals with no co-pays to policy holders. This last benefit, free routine annual physicals will help reduce the need for expensive surgical procedures by catching illness in their early stages. In many instances, when caught early, illnesses can be controlled and do not grow into a catastrophic ordeal. In 2014, all adults needing coverage can’t be denied do to a pre-existing condition.