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 actual 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 only required to make sure that any health benefits they do offer do not discriminate based on health status.
• If you get a new job with health benefits, your coverage may not start right away. Employers can require waiting periods before your health benefits begin. HMOs can require affiliation periods.
• If you are joining a group health plan and have a break in coverage of 63 days or more, you may have to satisfy a new pre-existing condition exclusion period.
• Even if your coverage is continuous, 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 Michigan, not all of the group health plan protections may apply to you.
• In Michigan, your access to individual health insurance may depend on your health status. Individual health insurers other than Blue Cross Blue Shield of Michigan and HMOs are free to turn you down because of your health status and other factors.
• Even if you are HIPAA eligible, you can be turned down for individual health insurance polices. Only Blue Cross and Blue Shield will guarantee issue policies to HIPAA eligible individuals and give credit for prior coverage. Other insurers, including HMOs, may impose pre-existing condition exclusion periods.
• You may have to satisfy a new pre-existing condition exclusion period when you buy individual health insurance, even if your coverage has been continuous. The length of the exclusion period varies depending on the type of individual health policy that you buy.
• Except for health insurance purchased through Blue Cross Blue Shield, the law does not limit what you can be charged for individual health insurance. You can be charged substantially higher initial premiums because of your health status, age, gender, and other characteristics.
• If you move away from Michigan, you may not be able to buy individual health insurance in another state unless you are HIPAA eligible.
• If you are a small employer buying a group health insurance policy from an indemnity insurer, you can be charged more, within limits, based on health status, age, gender, and other factors of those in your group. Even with these limits, however, premiums can be significantly higher if someone in your group has a serious illness.