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 group health plan 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 include the same doctors that your old health plan did. (see Group Health Plans)

· Employers are not required to provide health benefits for their employees, so if you change jobs, your new employer may not offer your health benefits. If your employer offers health benefits, the decision on whether to offer you health insurance cannot be based on factors related to you health status. (see Group Health Plans)

· If you get a new job with health benefits, your coverage may not start right away. Employers can impose waiting periods before your health benefits begin. HMOs can impose affiliation periods. (see Group Health Plans)

· 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 group health plan. (see Group Health Plans)

· 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 group 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 one year before your new health plan will pay for drugs prescribed to treat a pre-existing condition. (see Group Health Plans)

· If you work for certain non-federal public employers in Pennsylvania, not all of the group health plan protections may apply to you. (see Group Health Plans)

· Individual health insurers in Pennsylvania, other than the Blue Cross and Blue Shield plans, are free to turn you down because of your health status and other factors. In addition, Blue Cross and Blue Shield Plans can turn you down if you apply for a non-guaranteed issue plan. (see Individual Health Plans)

· Even if you are HIPAA eligible, you can be turned down for some Blue Cross and Blue Shield individual health insurance policies. The law permits Blue Cross and Blue Shield to limit your choices to two plans, which must be comparable to others they sell in the individual market in Pennsylvania. (see Individual Health Plans)

· Individual health insurers are not required to credit prior continuous coverage against pre-existing condition exclusion periods. (see Individual Health Plans)

· Except in regards to individual health insurance policies sold 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 premiums because of your health status, age, gender, and other characteristics. (see Individual Health Plans)

· If you move away from Pennsylvania, you may not be able to buy individual health insurance in another state unless you are HIPAA eligible. (see Individual Health Plans)