If you lose covered under a fully insured group health plan in Michigan and meet other requirements, you are guaranteed the right to buy a conversion policy. This is an individual health policy sold by the insurance company that covered your former group.
When am I eligible for a conversion policy?
- In Michigan, you may be eligible for conversion coverage if you have been covered under your prior group health plan for at least 3 months immediately preceding your loss of coverage. In addition, when you apply you cannot be covered under or eligible for similar benefits through a group health plan or Medicare. To qualify, you must request conversion coverage within 30 days of losing coverage.
- If you are HIPAA eligible and elect a conversion policy, you will lose your HIPAA eligibility status.
What will a conversion policy cover?
- The benefits under a conversion policy may not be the same as those under your former plan. The conversion policy’s benefits may be less generous than those you used to have.
What about my pre-existing condition?
- Conversion policies cannot impose a new pre-existing condition exclusion period. However, you may have to satisfy any unfinished portion of any pre-existing condition exclusion period from your former health plan.
how much can I be charged for a conversion policy?
- Conversion policies may cost much more than your previous group health plan. There is no limit on what you can be charged for a conversion policy. You may be charged higher rates based on your health, age, gender, and other factors.
Can my policy be cancelled?
- Your conversion 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.
