Guaranteed Health Insurance
The term “guaranteed issue” is used to describe a scenario where regardless of health status, a person is deemed eligible for health insurance coverage. As of 2014, under the Affordable Care Act (ACA), all new policies in the individual health insurance marketplace are guaranteed issue.
How is this different from a pre-existing condition insurance plan (PCIP)?
Under the ACA, all states offer a PCIP for individuals who have been denied coverage and who have not had health insurance for at least six months. Guaranteed issue laws are all encompassing – health insurance companies are required to issue coverage to any applicant, including those with pre-existing medical conditions.
Are there any exceptions to the Guaranteed Issue rule?
Yes. Grandfathered plans are exempt from most of the ACA’s regulations. A plan is considered grandfathered if it was in existence when ACA was enacted March 23, 2010.