Florida, like the majority of states, gives limited guarantees to anybody who wants to purchase individual health insurance and, despite the fact that your capacity to purchase health insurance will depend to some degree on your current state of health, there are situations where health insurance companies in Florida have to offer you insurance.
In general, health insurers are permitted to ask questions about your past medical history and to refuse you cover if you are currently suffering from a medical problem or have a poor medical history. More usually however insurers will offer to cover you, although they will either exclude particular conditions from your insurance plan or raise your premium and permit cover for these conditions. However, in Florida an exception to this rule applies in the case of a history of breast cancer as long as you have completed a course of breast cancer treatment a minimum of two years before your current application for insurance. Where this applies an insurer is not permitted to refuse to insure you.
As long as you have been covered by group insurance for a period of at least three months and subsequently lose that cover then, within Florida, you can buy a conversion plan and insurers are required to offer you the choice of a minimum of two policies. In addition, companies must not require any new pre-existing condition exclusion. However, they can enforce such an exclusion when you have not completed any previously imposed qualifying period.
If you do not qualify for a conversion plan but are HIPAA eligible then insurers cannot refuse to cover you and must offer you a choice of a minimum of two policies. To be HIPAA eligible you must have had a minimum of eighteen months of creditable continuous coverage (the final day of which has to have been under a group insurance policy) and have used up any COBRA or continuation coverage for which you were eligible. In addition, you cannot currently have health insurance (or your current group cover must be about to expire) and cannot be eligible for another group insurance policy or for Medicaid or Medicare. An application for health insurance coverage on the basis of HIPAA eligibility has to be completed within 63 days of losing your previous coverage.
If an insurer or HMO is no longer able to give you cover, because they have for example ceased trading or you have moved outside of their service area, then other insurers are required to offer you insurance coverage whatever your state of health.
Newborn children, newly adopted children and children placed for adoption must be covered under a parent's individual insurance plan for a period of 31 day from the date of birth, adoption or placement.
Under Florida law a disabled child is to continue to enjoy the benefit of cover when dependent coverage has been in issue past the age at which such cover would usually be ended, as long as the child is unable to support himself or herself as a consequence of physical or mental disability and is dependent on the policyholder for support.
In Florida the cover offered by an individual health insurance plan will be largely dependent on the plan that is purchased but Florida law requires that all policies provide cover for certain benefits such as mammograms, diabetes treatment and childhood immunizations. The full list of compulsory benefits is updated from time to time and an up-to-date list is available from the Florida Department of Financial Services.