If you lose coverage under a fully insured group health plan in South Carolina 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 South Carolina, if you are recently divorced and have coverage through your former spouse’s fully insured group health plan, you are eligible to buy conversion coverage. This is a policy you get from the company that insured your previous group plan. To qualify, you must apply within 60 days of the divorce decree.

• In addition, if you are a dependent child and have recently aged off your parent’s group plan, you are eligible to buy conversion coverage. To qualify, you must apply within 30 days of the date of termination of your prior coverage.
• HMO enrollees who lose individual health insurance are also eligible for conversion coverage.

What does a conversion policy cover?

• Insurers are required to sell you the policy they offer that is most similar to your terminated policy. Even so, covered benefits might not be the same as under your prior group policy.

what about coverage for my pre-existing condition?

• Conversion coverage cannot impose new probationary or waiting periods. However, you might have to satisfy the unexpired portion of any pre-existing condition exclusion period from your former health plan.

What can I be charged for conversion coverage?

• In South Carolina, generally there are no limits on how much conversion coverage premiums can vary due to age, gender, health status, family size, and other factors.

Can conversion coverage be canceled?

• 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.