What Are the Limits on My Protections?

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 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. If your employer does offer health benefits then the decision on whether to offer you health insurance cannot be based on factors related 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) 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.
  • If you work for certain non-federal public employers in Wyoming, not all of the group health plan protections may apply to you.
  • In Wyoming, 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.
  • In most cases 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 are HIPAA eligible, the Wyoming Health Insurance Pool is your only guaranteed access to individual health insurance, though you may be able to buy individual health insurance from other insurance companies.
  • If you join the Wyoming Health Insurance Pool and are not HIPAA eligible, you may face a pre-existing condition exclusion period.


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