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HIPAA Health Insurance

What is HIPAA (sometimes incorrectly referred to as HIPPA)? How can the HIPAA laws help me in obtaining health insurance coverage? Why should I even care about HIPAA? You may find the HIPAA laws as a very integral part to helping you to find comprehensive and low cost individual health insurance coverage.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was designed to help those people who have kept continuous health insurance coverage and for reasons beyond their control are unable to continue or obtain health insurance coverage.

One of the main things that HIPAA was designed to combat is the idea of “Job Lock”. Job lock is a situation where an individual wants to leave their job but they still stay at their job because they are on the employer’s group health plan. The employee does not want to leave the job and its benefits behind because the employee is concerned that they will be unable to obtain any other coverage due to a major health problem.

HIPAA plans are individual health insurance plans that are most of the time exactly like a regular individual health insurance plan from top companies like United Healthcare, Blue Cross Blue Shield, Aetna, Humana, Celtic, etc. The only difference is that the HIPAA individual health insurance plan is underwritten on a guaranteed issue basis. That means that an individual with a health issue such as cancer or diabetes that would most likely cause them to get turned down for a fully underwritten regular individual health insurance plan will be approved if they meet the criteria for a HIPAA eligible plan.

There are 6 criteria that must be met in order to qualify for a HIPAA eligible individual health insurance plan.

1. You must not have any other health insurance coverage (or it will be involuntarily terminated soon - for example: the end of your 18 months or 36 months under COBRA coverage is approaching soon). If you are offered benefits at a new employer then the moment that you become eligible for those benefits you cease to be eligible for a HIPAA plan.

2. You have been insured by creditable coverage (creditable coverage being defined as having a full comprehensive major medical policy and not just a plan that is supplemental in nature or insures only against accident, disability, or liability) for the last 18 months or more with no lapse of coverage of more than 63 days.

3. Your most recent coverage was under a group health plan, a governmental plan, or a church plan; or under an individual plan that terminated due to: the insurer's insolvency, the insurer's discontinuance of all its individual coverage in your particular area; or the fact that you no longer live in the service area of your prior insurance company.

4. Your most recent coverage was not terminated due to nonpayment of premiums, fraud, or intentional misrepresentations.

5. You are not eligible under a conversion plan, a group health plan, Medicare, or Medicaid.

6. You accepted and exhausted any group continuation of coverage (including COBRA) that was offered to you.

If these six requirements are met then you are eligible for a HIPAA guaranteed issue individual health insurance plan. Almost all health insurance companies offering individual health insurance have to have at least one individual health insurance plan that is HIPAA compliant.

Be a discerning insurance shopper and compare the top individual health insurance plans from multiple companies in your home zip code by requesting free health insurance quotes now!