When am I eligible for a conversion policy?

• If you were covered under a fully insured group health plan and you leave your job, you are able to buy a conversion policy. You are also able to buy a conversion policy at the end of your state continuation coverage. A conversion policy is an individual health insurance from the insurance company that covered your former group. You cannot buy a conversion policy if you are eligible for Medicare or if you have another health plan that covers pre-existing conditions.

What will a conversion policy cover?

• Conversion policy benefits must meet certain minimum benefit requirements, which may not be the same as those under your former plan.

What about coverage for my pre-existing condition?

• Conversion policies cannot impose a new pre-existing condition exclusion period. However, you might have to satisfy the unexpired portion of any pre-existing condition exclusion period from your former health plan.

What can I be charged for a conversion policy?

• There is no limit on what your insurer can charge for a conversion policy. Premiums are determined based on the age and classification of risk of each person applying for a converted policy. These policies are often more expensive than your prior group coverage.

Can my conversion policy be canceled?

• Your coverage cannot be canceled because you get sick. This is called guaranteed renewability. You have this protection provided that you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area.