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 (HMO’s) can require waiting periods before your health benefits begin.
- If you have a break in coverage, you may have to satisfy a new pre-existing condition exclusion period when you join a new 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 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.
- In Rhode Island, unless you are eligible for a guaranteed issue policy, individual market insurers can refuse to sell you individual health insurance because of your health status.
- Even if you are HIPAA eligible or have one year of prior health plan coverage, you can be turned down for some individual health polices. The law permits insurance companies to limit your choices to two plans, which are supposed to be comparable to others they sell in the individual market in Rhode Island.
- 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.
- If you move away from Rhode Island, you may not be able to buy individual health insurance in another state unless you are HIPAA eligible.
