What Factors Affect California Individual Health Insurance?
When looking for individual health care insurance, several factors should be evaluated before selecting a policy. There are the differences between HMO vs. PPO type policies, the level of out of pocket costs (yearly deductibles and co-payments), and the financial strength of the insurance provider to consider. But, possibly, the most significant criterion to impact your coverage is the insurance provider's practices on medical underwriting of new applicants.
The medical underwriting requirement for individual health insurance policies is very different from practices in group health care programs. In accordance with the law, in a group insurance plan, there cannot be discrimination in coverage levels applied to any group member based on that member's health status. In contrast, for individual insurance plans, discrimination resulting from an individual's health status is routinely practiced today and is totally legal! If a new applicant for an individual health insurance policy has a disability or existing medical condition, the insurance provider is free to deny coverage to the applicant or may offer only coverage that excludes the health disability or condition.
This practice occurs because of the required medical underwriting of each new health insurance policy which applies to many newly issued policies purchased in the individual insurance marketplace. What the concept of medical underwriting really means is that the insurance provider is analyzing the potential financial risk attributable to the new policy due to the health status of the individual. When applying for new health coverage, consumers must always call the medical underwriting staff of the insurance provider first to learn how they treat various health issues.