What Factors Affect New Mexico Individual Health Insurance?
When researching individual health insurance plans, several key factors must be considered before choosing a policy. There is a choice between HMO and PPO categories of plans, the level of out of pocket expenses (annual deductibles and co-pays), and the financial strength of the insurance company to evaluate. But, the most important factor to modify your coverage is the health insurance company's practices on the medical underwriting of applicants for new policies.
Medical underwriting of individual health care policies is somewhat different from what happens with group insurance programs. Per the law, in a group health plan, there should be no discrimination in benefits offered to any individual in the group based the person's health status. However, for individual health insurance plans, discrimination as a result of the health status of the person is actively performed now and is generally legal! If a person who applies for an individual health benefits plan has an existing medical condition, the insurance company is free to deny insurance to the applicant or to offer only insurance that excludes the medical condition or disability.
This will occur because of the necessary medical underwriting of each individual insurance policy which applies to the majority of new policies purchased by consumers in the individual insurance marketplace. What medical underwriting actually means is that the health insurance company is analyzing the likely financial risk under the proposed policy based on the specific health status of the individual. When considering a new insurance policy, consumers should call the medical underwriting organization of the insurance company early in the process to see how they deal with specific health issues.