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Florida HIPAA Health Insurance

Florida health insurance was impacted in a very positive way 10 years ago. The Health Insurance Portability and Accountability Act of 1996 (HIPAA although commonly mistakenly referred to as HIPPA) puts limits on pre-existing condition exclusions in group health plans and gives new enrollees credit for prior coverage.
In addition to these “portability” requirements, the law also makes it illegal to use health status as a reason for denying coverage, guarantees group coverage for employers with 50 or fewer employees, and guarantees renewability of group health plans.
While searching for insurance, you may have come across Florida HIPAA health insurance and not quite understood how it applies to you. This article will help you grasp where HIPAA health in Florida came from, what it means, and if it’s the most cost effective solution for you.


Defining Florida HIPAA
Health Insurance


HIPPA stands for Health Insurance Portability and Accountability Act. This Federal law, as well as laws from Florida that compliment its provisions, protects many important insurance situations such as continuation of coverage and privacy of your medical records.


Portability Of Florida
HIPAA Health Insurance


The first part, portability, refers to the protection of individuals who have to switch insurance companies or programs for a number of reasons. Instead of being held to unreasonable waiting periods for pre-existing conditions, this law puts a limit on the time of the waiting period, depending on the condition of course.


This portion of the law also protects against submittals to the medical underwriting departments at insurance companies for certain situations.  This protection is referred to as guaranteed-issue, and it is just as it sounds. It means that for qualifying situations, the individual may be guaranteed an immediate policy, eliminating the waiting period by the underwriting department.  Guaranteed-issue policies include coverage for a pre-existing condition, coverage for newborns or newly adopted children, and credits for prior coverage.


Health Care Privacy And
Florida HIPPA Health Insurance


The second portion of this law relates to health care privacy, something many of you may have more familiarity with after filling out all the HIPAA forms at the doctor!  This part of the law states that your medical information can only be shared for intentions of payment, health care operations and treatment.  For example, your primary care doctor is able to disclose your health conditions to another doctor you are seeing for purposes of treatment, with or without your consent.
Congress recognized the need for national patient record privacy standards in 1996 when they enacted the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The law included provisions designed to save money for health care businesses by encouraging electronic transactions, but it also required new safeguards to protect the security and confidentiality of that information. The law gave Congress until August 21, 1999, to pass comprehensive health privacy legislation. When Congress did not enact such legislation after three years, the law required the Department of Health and Human Services (HHS) to craft such protections by regulation.
There are 5 parts to HIPAA’s Administrative Simplification:

  1. Electronic Transactions
  2. Standards Requirements
  3. Privacy Requirements
  4. Security Requirements
  5. National Identifier Requirements

Florida health insurance had integrated components affected. HIPAA calls for changes designed to streamline the administration of health care. It promotes uniformity by adopting transaction standards for several types of electronic health information transactions. No longer can every insurer have unique requirements for the processing of claims. Everyone covered by HIPAA will be required to provide the same information – standard formats for processing claims and payments; as well as for the maintenance and transmission of electronic health care information and data.


How To Qualify For Florida
HIPAA Health Insurance


HIPAA is designed to protect those who have just changed jobs, lost their job, or are moving to another area.  There are other situations that it is useful, but there are strict requirements to be eligible for HIPAA health insurance. To qualify for HIPAA in Florida, you must meet the following requirements:


  1. You are not eligible for Medicare, Medicaid, a different group health plan or a conversion plan.
  2. You have already used up your COBRA allowance.
  3. You do not have any other insurance.
  4. The plan that you last had must have been a full medical insurance policy and been in effect for the last 18 months with no more than 63 lapsed days of coverage.
  5. This policy also could not have lapsed due to any of the following: non-payment of premium, misrepresentations or fraud.
  6. Finally, this policy must have been through a governmental insurance plan, group coverage or through your employer.  If it was an individual plan, the lapse can only be due to you no longer being within limits of Florida policy, the insurer went bankrupt or the insurer stopped offering individual plans.


After reading over these eligibility questions and finding you qualify, you must ask yourself if HIPAA is the best route for you. Generally HIPAA policies will be double or triple the amount you will find for a regular Florida individual policy.

However, if you have a pre-existing condition such as cancer or a heart condition, this may be the better choice of insurance because you will probably not be approved for coverage with a regular individual health insurance plan.

As always, it is best to consult about your personal situation with a licensed insurance agent to find the best option for you.

Florida HIPAA Health Insurance Awareness

While HIPAA makes certain that qualifying individuals receive coverage without long waiting periods for pre-existing conditions, it does not guarantee equal coverage to what the individual was receiving with their last policy.  It also does not offer competitive rates, and often times charges up to 200% of what an individual policy would charge.

Although keep in mind, if you are coming off of COBRA or some other form of group health insurance coverage then your FL HIPAA health insurance rate will probably be close to what the group plan costs. Again, because individual health insurance in Florida is so much cheaper than group health insurance that even with a HIPAA rate of double the normal individual health insurance rate then you will still pay a premium that is close in price to a typical group health insurance rate.

Finally HIPAA does not regulate group or employee plans to make sure they are offering adequate coverage. This is a temporary coverage offered in a time of need, and it helps individuals that typically have a difficult time finding insurance due to a pre-existing condition or who were in trouble in the past due to “job lock”.

Find Florida HIPAA Health Insurance Quotes Now!

By using our free search tools at the top of the page, you can find out if Florida HIPAA health insurance is the way to go for you.

Start searching to protect you and your family!

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