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Understanding Guaranteed Acceptance Health Insurance

Have you had difficulty finding health insurance due to cost or pre-existing conditions? You might consider guaranteed acceptance health insurance, also known as guaranteed issue health insurance.

What is guaranteed issue health insurance?

It is simply health coverage for which you cannot be turned down regardless of age or pre-existing conditions.

What is the difference between guaranteed issue insurance and traditional health insurance?

Traditional health insurance pays your doctor based on the actual cost of treatment in your particular area. Guaranteed issue insurance, while referred to as "insurance" is not usually considered creditable coverage. Most such plans pay a pre-determined coverage amount—called an indemnity—regardless of what the doctor charges. Others do not pay the doctor at all, but simply work with your providers to negotiate a lower price for you. You will need to ask a lot of questions and examine your policy closely.

If it isn't creditable coverage, why should I even bother with it?

If you are unable to purchase traditional health insurance, having a plan that pays something is better than nothing at all. Usually these plans are quite inexpensive, and many will reimburse you directly along with traditional  insurance.

Will there be waiting periods for pre-existing conditions?

There can be. You will need to check the policy to find out.

Will a guaranteed acceptance policy pay both the doctor and hospital?

Yes, a good plan will pay a specified amount per day to a hospital and will usually pay a doctor as well. You will need to see if your doctor accepts the plan. Also, there may be limits such as only 3 visits per year to a doctor, or one trip to an emergency room.

What is meant by "insurable benefits"?

Most guaranteed issue plans are not true insurance, but are often marketed as having "insurable benefits." This can apply in different ways, such as prescription drug coverage, or insurable coverage for vision and dental. Insurable benefits simply refer to certain types of health care that are covered in the same way as they would be if the plan were regular health insurance.

When should a person by guaranteed acceptance health insurance?

The only time a person should purchase this type of insurance is if you cannot afford or have been declined for traditional insurance, including PPO and HMO plans. Often an HMO, in spite of requiring you to work within a defined network, will be less expensive than the traditional fee for service policies. If you are in good health and can afford creditable coverage insurance, it will always provide better coverage.