Private Health Plans

Lately, I have discovered how difficult it is establish Private Health Plans for private health insurance in the United States. I was resigning from my group and needed private health insurance coverage. Through the support of my insurance agent, I have made the first online application in less than an hour.

That was the easy part.

One week after completing the application, I have a follow-up call to my application from the medical department of the company. I was told to check some information on my application.

Now we are in troubled waters.

Since the exact details they wanted were in my medical records with my doctor, their questions couldn't be immediately answered.

I'm not sure why they did this because when I referred them to my doctors, they got the answers they needed, without the fuss.

Because of my experience, I did some research. It helped me to the following list of ten things I think every application for private health insurance in the United States should know. I hope that this list will help you or someone you know to avoid what happened to me.

Before you apply

Do not let your policy expire before the searching for new cover.

If your policy is canceled, you can switch to the Consolidated Omnibus Budget Reconciliation Act (COBRA). This law ensures continuation of group health insurance that otherwise might quit. For more information see: http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html

Talk to your doctor about your medical records before you apply. Private health plans have stringent disclosure requirements.

For private health plans, insurance companies can investigate your medical history as far back as ten years. Hence, make sure your records are up-to-date and talk to your doctor(s) on all matters of health, especially those that might cause red flags.

Obtain copies of medical records.

You can also call for a copy of your medical records under the Health Insurance Portability and Accountability Act (HIPAA). For more information about HIPAA, go to http://www.privacyrights.org/fs/fs8-med.htm

Find out what your state government policy is in relation to private health plans.

Each State may provide for certain exceptions or deviations in relation to cover. Most of this information is published online. Visit your state government website and search for "Private health insurance" or "health insurance" or "private health plans ".

Verify that you have a file with the Medical Information Bureau (MIB).

The MIB is a central database of medical information pooled by major insurance companies. If you are on the database, get a free copy (once per year) by calling (866) 692-6901, or visit the company's website at http://www.mib.com/html/request_your_record.html.

Please contact a qualified independent insurance broker who deals with private health plans.

An insurance agent will know the private insurance for you and can help you through the application process. Locate an medical insurance agent in your area, please visit: http://www.nahu.org/consumer/findagent.cfm

Obtain a copy of the application and check before using it.

Some companies may deny a claim or cancel the policy solely because the information in the application is inaccurate. If you have omitted something accidentally, it could cause problems. Read over your application carefully to ensure that you have answered all the questions accurately.

If you have a follow-up call: answer only the questions asked. Don't volunteer further information.

Be polite and remember the interviewer is not your friend or your doctor. In these types of interviews, you have no privacy. In addition, the interview will most likely be taped so think before you answer.

If you do not know the answer to a question, be honest about it.

I recommend you become very comfortable with the words: "I do not have that information, please contact my doctor." When asked specific questions about medical procedures best not to guess, refer them to your doctor(s) and your medical data.

Be honest and keep to the facts in relation to your medical history.

The company who has your application may also have your MIB records and may already be privvy to your medical history. If you are caught, you can be refused. Most applications ask if you ever been refused health insurance, and a denial may be an immediate "red flag" on all future applications.