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 health benefits with you. Except when you exercise your federal COBRA or state continuation rights, you are not entitled to take your group health coverage 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. Employers are 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 health maintenance organizations (HMOs) 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 coverage, there may be a pre-existing condition exclusion period for some benefits if you join a 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 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 Louisiana, not all of the group health plan protections may apply to you.
- In Louisiana, your access to individual health insurance may depend on your health status. Private insurers in Louisiana are not prohibited from turning you down, charging more or limiting coverage because of pre-existing conditions.
- Even if you are HIPAA eligible, you can be turned down for individual health insurance policies. Louisiana Health Plan coverage is your only guaranteed access to individual health insurance, though you may be able to buy individual health insurance from other insurance companies.
- If you apply for Louisiana Health Plan coverage and are not HIPAA eligible, you may face a pre-existing condition exclusion period.
- If you are a small employer with only 2, or more than 35 employees, there are no limits on what you can be charged because of the health status, age, or other characteristics of those in your group.
