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 any health benefits they do offer do not discriminate based on health status.
• If you get a new job with health benefits, your coverage may not start right away. Employers can require waiting periods before your health benefits begin. Health maintenance organizations (HMOs) can require affiliation periods.
• 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.
• Even if you have continuous coverage, there may be a pre-existing condition exclusion period for some benefits if you join a self-insured 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 a self-insured group 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.
• If you work for certain non-federal public employers in South Dakota, not all of the group health plans protections may apply to you.
• In South Dakota, your access to individual health insurance may depend on your health status. Private insurers are not prohibited from turning you down, charging you more, or limiting coverage because of pre-existing conditions.
• Once you obtain individual coverage, your ability to switch plans may be limited as well. While you have protections when you move from an individual policy to a group plan, South Dakota law does not protect you from the imposition of an elimination rider when you move from one individual plan to another, even if you had prior continuous coverage. Furthermore, you are not assured the right to buy another individual policy.
• If you are a small employer buying a group health insurance policy, you can be charged more, within limits, based on health status, age, gender, and other factors of those in your group. Even with these limits, however, premiums can be significantly higher if someone in your group has a serious illness.