What Factors Affect Washington Individual Health Insurance?
When learning about individual health care insurance policies, multiple key factors must be evaluated before selecting that final policy. There are differences between HMO and PPO programs, the degree of out of pocket fees (yearly deductibles and co-pays), and the financial resources of the insurance provider to consider. However, possibly the most significant factor to affect your insurance coverage is the health insurance provider's practices on the medical underwriting of individual applicants.
The practice of medical underwriting for individual health benefit policies differs dramatically from what is required for group insurance plans. Per the law, in a group health insurance plan, there should not be discrimination in coverage provided to any individual member of the group based on the individual's health status. In contrast, for individual health insurance plans, discrimination due to the individual's current health status is routinely performed now and is considered completely legal! If any person who applies for an individual health insurance plan has a medical disability or pre-existing health condition, the insurance provider is free to refuse insurance to the applicant or may provide only health coverage that excludes the disability or condition.
This practice results from the process of medical underwriting of every individual health insurance policy which is applied to most new policies bought in the open marketplace. What the concept of medical underwriting actually means is that the health insurance provider is evaluating the financial risk attributable to the proposed policy based on the specific health status of the applicant. When thinking about new health insurance, consumers would be wise to talk to the medical underwriting specialists of the insurance provider early in the process to learn more about how they will respond on specific health conditions.