As is the case in the majority of states, Florida grants limited guarantees to anybody who wants to purchase individual health insurance and, while your capacity to purchase health insurance will depend to a certain extent upon your current state of health, there are circumstances in which health insurance companies in Florida have to offer you insurance.
Generally, health insurance companies are allowed to ask questions concerning your past medical history and to refuse you cover if you are suffering from a current medical problem or have a poor medical history. More usually however insurance companies will provide you with cover, although they will either exclude particular conditions from your insurance cover or raise your premium and cover such conditions. In Florida however one exception to this rule applies in the case of a history of breast cancer as long as you have completed a course of treatment for the condition at least two years before your current request for insurance. In this case insurance companies are not allowed to refuse to insure you.
When you have been insured under a group insurance plan for a period of at least three months and then lose that cover then, in Florida, you have the right to purchase a conversion policy and insurance companies must offer you the choice of at least two policies. In addition, companies must not inflict any new pre-existing condition exclusion. However, they can enforce such an exclusion where you have not completed any previous qualifying period.
Where you cannot qualify for a conversion plan but are HIPAA eligible then insurance companies must not refuse you cover and must offer you a choice of at least two policies. HIPAA eligibility requires that have had at least 18 months of creditable and continuous coverage (the final day of which must have been under a group insurance plan) and have used up any eligible continuation or COBRA coverage. Additionally, you must not currently have health insurance (or your current group plan cover must be about to expire) and must not be eligible for another group insurance plan or for Medicare or Medicaid. Finally, an application for health insurance coverage under HIPAA eligibility has to be completed within 63 days of the loss of your prior coverage.
When an insurance company or HMO can no longer give you cover, because they have for instance become insolvent or you have moved out of their service area, then other insurance companies have to offer to provide you with insurance coverage whatever your state of health.
Newborns, newly adopted children and children who are placed for adoption have to be covered under a parent's individual insurance policy for a period of 31 day from the date of birth, adoption or placement.
Under Florida law a child who is disabled will remain covered when dependent coverage has been in issue beyond the age when cover would normally be ceased, as long as the child is not able to support himself or herself because of physical or mental disability and is dependent upon the planholder for support.
In Florida the cover afforded by an individual health insurance policy will depend to a large degree upon the particular policy that is purchased but Florida law requires that all policies give cover for a number of benefits such as diabetes treatment, childhood immunizations and mammograms. The full list of mandated benefits is updated from time to time and an up-to-date list may be obtained from the Florida Department of Financial Services.
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