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california individual health insurance
Basic surgical coverage can be included in the same policy as basic hospital and medical expense and are normally included in a schedule listing major commonly performed operations and the benefits payable for each. This gets a bit tricky and you need to be aware of how the insurance company determines the benefit.
Businesses that offer group coverage are subject to certain provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). Terminated employees of companies that regularly employ more than 20 people may be eligible for extended group health insurance coverage after they leave their jobs.
To find out about each state's specific requirements regarding individual health insurance policies, please see NAHU's Health Care Coverage Options Database. The database also contains contact information for the state regulators of individual health insurance policies to use if you have questions or concerns.
Complaints. HMOs must be set up to handle coverage complaints and care complaints. HMO members must receive a document that spells out how complaints can be registered.
Individual health insurance companies are much more limited than group insurance companies in their ability to spread risk, so the laws concerning i ndividual health insurance are different in most states. This means that applicants for individual insurance will need to complete a brief medical questionnaire when applying for benefits and, unlike a group insurance policy, in most states a company can decide not to cover people with very serious medical conditions (e.g., HIV or cancer), deeming them “uninsurable.”
Deductibles are the amount of the covered expenses you must pay each year before the insurer starts to reimburse you. These might range from$100 to $300 per year per individual, or $500 or more per family. Generally, the higher the deductible, the lower the premiums, which are the monthly, quarterly, or annual payments for the insurance.
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