When am I eligible for a conversion policy?

• In Missouri, if you have coverage through an employer’s fully insured group health plan for at least 3 months and you lose that coverage, and you are not eligible for other group coverage, you are eligible to buy a conversion policy. A conversion policy is an individual insurance policy that you buy from the company that insured your employer’s group plan.
• To qualify for a conversion policy, you first must have used up any COBRA or state continuation coverage.
• You do not need to be HIPAA eligible to buy a conversion policy. However, if you do elect a conversion policy, you will lose your HIPAA eligibility status.

What does a conversion policy cover?

• The benefits under a conversion policy will probably not be the same as those under your former plan. The conversion policy’s benefits may be less generous that those you used to have.

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 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. Contact the Missouri Department of Insurance if you have questions about conversion policy premiums.

Can my conversion policy be cancelled?

• Conversion policies, like other individual health insurance policies, are guaranteed renewable. Your coverage cannot be canceled because you get sick. 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’s service area.