What Factors Affect North Carolina Individual Health Insurance?
When researching individual health insurance, several key factors should be considered before choosing a policy. There is a choice between HMO and PPO type plans, the level of out of pocket expenses (annual deductibles and co-payments), and the financial strength of the insurance company to evaluate. But, the most important criterion to modify your coverage is the insurance company's practices on the medical underwriting of applicants for new policies.
Medical underwriting of individual insurance policies is somewhat different from what occurs in group insurance programs. Per the law, in a group health plan, there can be no discrimination in benefits offered to any member of the group based the person's health status. However, for individual health insurance plans, discrimination based on the health status of the person is actively practiced today and is generally legal! If a person who applies for an individual insurance policy has an existing medical condition, the insurance company is free to refuse coverage to the applicant or to offer only insurance that excludes the medical condition or disability.
This will occur because of the medical underwriting of each individual insurance policy which applies to most new policies purchased by consumers in the individual insurance marketplace. What medical underwriting actually means is that the insurance company is analyzing the likely financial risk under the new policy based on the specific health status of the individual. When considering a new insurance policy, consumers should always call the medical underwriting organization of the insurance company first to see how they deal with specific health issues.