As important as they are, the federal and state health insurance reforms are limited. Therefore, you also should understand how the laws do not protect you.
- If you change jobs, you usually cannot take your old group health benefits with you. Except when you exercise your federal COBRA rights, you are not entitled to take your group health plan with you when you leave a job. Your new health plan may not cover all of the benefits or the same doctors that your old plan did.
- If you change jobs, your new employer may not offer you health benefits. If your employer does offer coverage, it is required only to make sure that their decision is based on factors unrelated to your health status.
- If you get a new job with health benefits, your coverage may not start right away. Employers and managed care organizations (MCOs) can require waiting periods before your health benefits begin.
- If you have a break in coverage of 63 days or more, you may have to satisfy a new pre-existing condition exclusion period when you join a new plan.
- Even if your coverage is continuous, there may be a pre-existing condition exclusion period for some benefits if you join a self-insured group health plan that covers benefits your old plan did not. For example, say you move from a group plan that does not cover prescription drugs to one that does. You may have to wait up to six months or one year before your new health plan will pay for drugs prescribed to treat a pre-existing condition.
- If you work for certain non-federal public employers in Idaho, not all of the group health plan protections may apply to you.
- Individual health insurers, other than HRP plans, can turn you down or charge you more for coverage based on your health status.
- Unless you are HIPAA eligible, you may not be able to purchase individual health insurance in another state.
