Health Insurance Consumer Protection

By: Mevish Jaffer

If you value your wellbeing then you know how important it is to have a health insurance plan. Not only is it vital to have insurance for annual check-ups, but you also never know when a medical emergency may come up. Although it’s not something you may want to think about, life does have a way of being extremely unpredictable and you can never be too prepared for health-related issues that may arise unexpectedly, especially since they don’t only affect you, but your entire family as well.

Along with your health plan, there are also certain health insurance laws in place to ensure your security in the case of unforeseen fluctuations. Whether you are receiving group coverage through your employer or are on an individual plan, you need to be aware of the rules and regulations that govern your health insurance consumer protection rights.

Consumer Protection Laws

If you are a small business owner or employee, there are two federal laws that influence the coverage of your health insurance that you should know about. These include:

  • HIPAA Health Insurance Profitability and Accountability Act
  • COBRA Consolidated Omnibus Budget Reconciliation Act

HIPPA initially went into effect in 1996 with the purpose of providing important health insurance protection for small businesses and their employees. The Health Insurance Profitability and Accountability Act doesn’t allow health insurance companies to discriminate against employees and dependents based on their health condition. Basically, whether you’re a small business owner, an employee or a dependent, you are entitled to eligibility and cannot be denied. Furthermore, this consumer protection law prohibits extra charges for coverage. HIPPA also provides guaranteed health insurance renewal to self-employed individuals with limited exceptions.

Another federal law that affects the coverage of your health insurance is the COBRA act, which originally went into effect in 1986. Under the Consolidated Omnibus Budget Reconciliation Act, employees as well as their dependents are granted continued coverage of their employer-sponsored group health insurance policy for a restricted time period after their job has ended. To break it down further; if you are the employer and you have a staff of 20 or more, your employees will qualify for ongoing COBRA coverage should they retire, terminate employment, get fired or change their schedule to work lesser hours. The time frame of COBRA coverage is generally a period of 18 months, however can be increased to up to 36 months based on special eligibility conditions.

State Consumer Protection Laws

Some states mandate health insurance companies to provide coverage to individuals even though they may be suffering from chronic illnesses while others may not extend this type of coverage. Because every state has varying health insurance consumer protection laws, it’s up to you to find out exactly what the health insurance rules and regulations are in your state so you can be fully aware of your rights as an insured individual.

No matter what your individual circumstances might be, don’t give up on getting health insurance as it is an essential part of your life and your family’s. Get your information on the Internet or consult with knowledgeable friends to find out what your health insurance options are.



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