Guaranteed Issue Health Insurance

The first thing you need to look for when shopping for health insurance, particularly if you have a preexisting condition and can not get coverage elsewhere, is whether the plan you are looking at is major medical coverage or not. Usually this is taken for granted, that would be a big mistake in this case. What exactly is a "major medical health insurance plan"? Major medical insurance covers any medically necessary service and particularly serious health expenses up to a certain amount (measured in the $ millions, not thousands). Coverage is usually subject to a deductible and coinsurance, although sometimes co-pays are involved. Once those preset amounts are paid, a major medical plan covers the remaining cost of medical care up to the policy limits (again, as measured in the millions not thousands).

Unfortunately, the Cover Florida plans are NOT major medical plans at all and not even remotely so. These are Defined/Limited Benefit Plans which place serious caps on benefits to the point of being almost useless. The irony is that these are sponsored by the State of Florida, and cover little in the way of anything except for routine and relatively inexpensive trips to the doctor for treatment. If you have a preexisting condition and thought this coverage would help, you have to wait a year before preexisting conditions are covered.

To give you an idea of what you'd be getting with a Cover Florida plan, it's easier to discuss what they don't cover rather than what they do:

If you have health insurance now, you cannot switch. These plans are for people who have NOT had health insurance for at least 6 months.
They do not cover any pre-existing conditions for at least one year.
They do NOT cover brand name prescriptions, only the cheap prescriptions Walmart and Publix sells for a few bucks.
United HealthCare’s plan will only cover 10 days in the hospital paying a maximum of $2,000 a day. There is no surgery coverage. Consider the cost of a serious illness like a heart attack or the costs associated with a car accident or spinal injury etc. Cover Florida only covers, $2000 a day in a hospital. We have Supplements that cover more then this.
And emergency room visits; $1,500 on the United plan. Great if you have a sprained ankle but for anything more serious, that might present a problem.
Child only coverage is not available.
Depending on where you live, a 40 year old male can pay up to $206 a month for the plan. A healthy 40 year old male in Central Florida with a $1,500 deductible for a full major medical plan and $5 million in coverage walks away for $160 a month from a major carrier. You do the math.

The Blue Cross plan, although cheaper, pays a maximum of $25,000 a year after you pay a $3,000 deductible. After the "per incident deductible", you pay 20% on EVERYTHING with no limits. If your hospital bill was $50,000, you would pay the $3,000 deductible and then 20% of the remaining $47,000, or $9,400. Or, a total of $12,400! But wait, they will only cover up to $25,000 a year. So your bill would be a lot more. Actually, it would be $25,000 out of your pocket plus the deductible.

Did you see any mention of coverage for chemotherapy, radiation, or kidney dialysis? What about the expensive brand name drugs that result from serious illnesses? I have clients with HIV and cancer that were spending a $1,000 a month and much more on medications, where's that leave them?

The cost of Cover Florida plans are about the equivalent of getting a true major medical plan with $5,000,000 coverage with a high deductible. To be fair however these plans are guaranteed issue meaning no one can be denied and they do offer good benefits for preventative care. However if the sole reason you are buying health insurance is to get relatively inexpensive medical costs covered, then why bother with the cost of health insurance at all? For other people who really are expecting coverage in the event something really serious happens, or even if you suspect it has happened and need tests, I hope you have plenty of money socked away and a strong belief in the power of prayer.

For a comparison on plan benefits and to make your own judgments. To look at more specific plan details follow this link for guaranteed issue health insurance from the State of Florida and United Health Care.