Joining a Group When You Do Not Have Health Insurance
One of the methods of obtaining health insurance in spite of your health condition is to go to work for an employer that provides health insurance benefits to employees.
As long as you can perform the job, you can't be asked health questions before accepting the job. See Americans with Disabilities Act.
Similarly, while no law requires an employer to offer health insurance or any other benefits, under the law generally known as HIPAA (The Health Insurance Portability and Accountability Act of 1996):
- An employer can determine who is eligible for health insurance. This means, usually, an active, full-time employee who is a member of the class to which health insurance is offered.
- If you become eligible for group health insurance because of your job, you cannot be refused that insurance because of a medical condition or health history. This guarantee of coverage only applies to health insurance. It does not apply to group life insurance or long term disability insurance although those coverages are typically offered without requiring answers to health questions because there is no medical underwriting by the insurer. HIPAA also does not apply to dental and vision insurance. However, these coverages are typically offered with health insurance as a package.
- Employers are permitted to postpone coverage for a pre-existing health condition for up to 12 months if you sign up for the group coverage as soon as you are eligible. If you delay enrolling, an employer can impose a waiting period of up to 18 months. See Pre-Existing Conditions for limitations on the definition of a pre-existing condition. During the waiting period any other health claims you have will be covered.
Under another federal law known as ERISA, you cannot be offered health insurance that's different from people who do not have a health condition. For example, an employer's health insurance cannot have a lifetime cap on medical expense of $1,000,000 except that for people with pancreatic cancer, the limit is $50,000. It should be noted that ERISA does not apply if the employer's health plan is self insured.
NOTE: For other means of obtaining health insurance despite an existing health condition, click here.