Personalized Employee Benefits Resources | PeopleKeep

10 Things to Know When Applying for Individual Health Insurance

Written by PeopleKeep Team | February 28, 2013 at 1:06 AM

Here are 10 things you need to know when applying for an individual health insurance plan:

  1. The application will likely ask for common information such as your name, address, Social Security number, marital status, dependents and whether any of the applicants have other health insurance coverage in place or are covered under Medicaid/Medicare programs.

  2. Be sure to include the date you would like coverage to be effective.

  3. Be detailed in the health information you provide about yourself and other family members desiring coverage. The information requested can vary, so pay close attention to the number of years of medical history required and the exact information requested.

  4. Note if anyone listed on the application has been previously declined health insurance, or had their health insurance canceled.

  5. If you answer "yes" to any of the background health questions, provide the name of the family member, their physician's information and the exact details regarding the dates and their nature of their condition.

  6. Obtain a copy of your medical records before completing the application to ensure you do not accidentally fail to disclose relevant information.

  7. A pre-existing condition may affect your coverage by either restricting coverage completely or for a specified period of time. However, once you are accepted for coverage, the policy may only be canceled for nonpayment of premium or deliberately providing false information on the application.

  8. Help may be available if you are turned down for individual coverage due to a medical or pre-existing condition, or find the policy is approved, but the premiums are too high. The state risk pool, HIPAA plans, Medicaid, the Children's Health insurance Program (CHIP) and Medicare may be resources.

  9. Review the application carefully to make sure answers are complete and accurate before signing it. Any dishonesty or failure to disclose requested or material information could result in coverage being terminated.

  10. If you have questions about this process or want clarification around pre-existing condition exclusions or options in your state if coverage is denied or premiums are too high, visit your state health insurance department website or ask your health insurance broker.

This blog post was last updated on February 27, 2013.