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HIPAA and the Individual

Nov 25th, 2009


Under the HIPAA Act of 1996 there are certain extenuating circumstances which can cause the loss of eligibility for coverage. This is a disconcerting event; however it does occur even though it is very rare. Some of the reasons responsible that can trigger the loss of health insurance coverage are the following.

1.               Marriage separation and or divorce

2.               The death of a spouse, or main insurance holder

3.               Exceeding the insurance plan lifetime limit

4.               A dependent is no longer a dependent

These are only a few of the main reasons; however through our website, there are more information waiting for the individual entrepreneur to read. What all of this does do is open up a new area for special enrollment. The self-employed must ask for enrollment within thirty days after the loss of eligibility of coverage or after a life-altering event.

No matter what happens from here, the individual entrepreneur will receive comprehensive affordable health insurance within a very short period of time Special enrollment because of marriage or the loss of eligibility of another insurance coverage the individual will receive a comprehensive plan within thirty days of submitting the request form.

However, conditions from domestic violence as well as free will participation of activities as snowmobiling, all-terrain vehicles, motorcycling, skiing and horseback riding are triggers for evidence of insurability. This means the individual will acquire health care insurance regardless of the circumstances at hand. What every individual needs to be aware of is the benefit exclusion of source of injury, which will affect the insurance benefits.

Though HIPAA does impact state laws, it works well in conjunction with the state of New York laws. New York laws passing recently prevent the insurance carriers from researching back into an individual’s medical history. This works very well and helps to stabilize the overall costs for all the residents of New York in a time when low cost health insurance is at a premium. At the time of enrollment is when the prospective insurance corporation has the opportunity to research an individual’s records.

According to state laws there is only a three month to six-month window that is available for research. Any incidents of credible health risk difficulties before the time frame stated is inadmissible for any insurance provider to research. These are only a few of the modern modifications instituted to benefit the individual and balance the insurance provider to have the ability to serve all citizens.

"Vista Health Solutions" www.nyhealthinsurer.com Tel (888)215-4045 Email [email protected]