Florida medical insurance coverage is comprised of two essential classes: Florida particular person medical insurance coverage and Florida group medical insurance coverage. These two classes have many similarities however but many vital variations as properly.Lukemedika
Many Florida residents are fairly accustomed to massive group medical insurance coverage by means of their employer if they’ve ever labored for a big company (in Florida a big group is taken into account an organization or group that has greater than 50 workers). Nevertheless, relating to understanding particular person medical insurance coverage in Florida and the way it works and even understanding small group medical insurance coverage in Florida and the way that works it seems to be considerably completely different than the massive group medical insurance coverage plan that almost all have identified so properly for thus lengthy.
Particular person medical insurance coverage in Florida is completely different from group medical insurance coverage in Florida due to the truth that the underwriting departments at every Florida insurance coverage firm will scrutinize very carefully any pre-existing circumstances that an applicant has of their well being historical past (going again as much as 10 years) if they’re making use of for a person coverage.
This scrutiny is geared in the direction of discovering any opposed well being circumstances or precursors to well being circumstances similar to diabetes, excessive ldl cholesterol, coronary heart illness, weight problems, most cancers, and many others. Circumstances similar to diabetes, most cancers, coronary heart illness and extreme weight problems will trigger a Florida medical health insurance firm to robotically decline an software for protection with a person medical insurance coverage coverage.
Much less extreme pre-existing well being circumstances similar to excessive ldl cholesterol, hypertension, gentle weight problems, and heartburn/acid reflux disease will typically lead to a rider being positioned on the accompanying coverage that may exclude protection for something associated to that particular pre-existing situation. Riders are typically levied on an indefinite foundation or a short lived foundation (12-24 months typically).
There are just a few insurance coverage corporations in Florida (one in every of them presently being Aetna) that don’t subject riders on the person medical insurance coverage facet as is commonest however will as a substitute “fee up” an applicant they deem presents extra threat as a consequence of pre-existing circumstances. This “fee up” merely signifies that they are going to provide to cowl the gentle pre-existing circumstances however they are going to give you a fee elevated premium quantity that may be 10% greater than was initially quoted you, 25% extra, 50% extra; all of it relies on the underwriting division on the insurance coverage firm as to what premium quantity that they are going to give you in the event that they resolve to just accept you.
Florida group medical insurance coverage is way easier in that typically there’s not as a lot scrutiny in the direction of an applicant’s well being historical past and pre-existing circumstances. That is good or dangerous relying in your current well being situation. It’s good in case you are an unhealthy particular person with some main pre-existing circumstances as a result of it permits you to get hold of group medical insurance coverage while you can be declined for those who tried to acquire particular person medical insurance coverage (as a consequence of your pre-existing circumstances). Nevertheless, it’s dangerous from a monetary sense in case you are a typically wholesome particular person since you are paying the next premium price for group medical insurance coverage (versus particular person medical insurance coverage) – that’s until your employer is paying the associated fee for your whole group medical insurance coverage: then you’re fairly comfortable (until you’ve gotten a household and your employer just isn’t so form as to pay for them to be on the group medical protection as properly!)
Simply from what you’ve gotten discovered up to now; which do you assume can be costlier – group medical insurance coverage or particular person medical insurance coverage? In case you stated group medical insurance coverage then you’re heading in the right direction to understanding the primary distinction between the 2. Consider the price of group medical insurance coverage versus the price of particular person medical insurance coverage like this: in case your new co-worker on the cubicle subsequent to you has most cancers then guess what? They’ll be capable to get hold of group protection in your group plan though they by no means can be authorised for a person medical insurance coverage coverage. You as a wholesome particular person are in a way subsidizing the price of your unhealthy co-worker (and all the different unhealthy folks) in paying their premiums. It follows after all that the premiums will probably be greater for a gaggle medical insurance coverage plan in Florida the place the insurance coverage firm has to tackle each wholesome and unhealthy folks versus a person medical insurance coverage plan in Florida the place the insurance coverage firm can decide and select who they are going to settle for.