Consumer's Guide to Getting and Keeping Health Insurance

Health insurance is a necessity in today's world. New and innovative medical procedures and medications have increased the cost of health care to the point where the average individual cannot afford to pay out-of-pocket for care. Unfortunately for many consumers, getting and keeping health insurance is not as simple as it seems. Consumers need to be informed of health care laws and take the appropriate steps to obtain and keep their health insurance.

Employer-sponsored Health Insurance

• Consumers who work for an employer that provides health insurance benefits should take advantage of the opportunity to enroll. Employer health plans are group insurance plans. These plans are more flexible than individual plans because plan participants are not subject to strict underwriting criteria to obtain coverage. Group plan participants are qualified to receive coverage, regardless of health condition or medical history. This means anyone who enrolls in an employer-sponsored plan can get and keep coverage as long as they remain employed. The same applies to the employee's dependents. Employer-sponsored plans are more cost-effective as well. In many cases, the employer must contribute to the cost of the health insurance.

Individual Health Insurance

• Consumers who are unemployed, self-employed or students can purchase an individual health insurance policy. These private insurance plans cover a specific individual and/or the individual's family. Individual health insurers have strict guidelines that plan participants must meet before they receive coverage. Getting insurance with an individual health plan is possible, but you must go through an underwriting process before being accepted for coverage. The process may involve undergoing a physical exam, an evaluation of your medical history and answering a long list of health-related questions. Once you pass the initial underwriting stage, you will remain covered for as long as you pay your premiums on time.

Maintaining Coverage

• As long as you pay your insurance premiums on time, your coverage will remain in force. Insurance companies cannot cancel your policy because of your health nor can they cancel your policy because you file an insurance claim. However, insurance companies may exclude conditions that were present before you obtained your policy and deny any claims you make related to such conditions. The insurance company may also rescind (cancel) your policy after it has been issued if it discovers that you failed to disclose or misrepresented information about your health status or medical history. One of the most effective ways to maintain your insurance is to be honest and upfront about your health prior to obtaining coverage. This will reduce the likelihood of probes into your medical history after you file a claim.

Picking a Health Plan

• Deciding which health plan to choose is a matter of weighing costs with benefits. Health insurance is expensive. You must consider how the potential health plan fits into your overall budget. You will also want to determine if a particular health plan covers all the services you will most likely use. For instance, you may choose a health plan based on a particular doctor within the plan's network. Or you may choose a plan based on the benefits it provides, such as prescription drug coverage or chiropractic care. Because all health insurers provide a variety of benefits and options, it is important to pick a health plan based on your specific needs and the needs of your family.