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 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. 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), which are also called health insuring corporations (HICs) can require waiting periods before your health benefits begin.
- If you work for one of a number of local governments or school districts in Ohio, not all of the group health plan protections may apply to you.
- 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 fully insured group health 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 certain 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 self-insured health plan will pay for drugs prescribed to treat a pre-existing condition.
- Except in the case of basic and standard health plans, your access to individual health insurance may depend on your health status. Private insurers are not prohibited from turning you down, charging more or limiting coverage because of pre-existing conditions. If you are HIPAA eligible or purchasing health insurance during an open enrollment period, you are only guaranteed access to basic or standard health insurance plans.
- If you move away from Ohio, you may not be able to buy individual health insurance in another state unless you are HIPAA eligible.
