Texas Guaranteed-Issue Health Plans
If you’ve been turned down for major medical insurance you have a new option: a guaranteed-issue plan.
Guaranteed-issue plans, also known as mini-med plans and defined benefit plans, are guaranteed-issue health insurance, which means anyone can buy them regardless of pre-existing health conditions. There is no underwriting and no health questions are asked.
The drawback of these plans is that they have defined limits on coverage and pay set amounts which means. Guaranteed Issue Health Insurance should not be looked at as a replacement for major medical insurance. These are defined benefit plans designed solely for people who aren’t able to obtain traditional major medical plans.
Who needs Guaranteed-Issue Health Plans?
A guaranteed-issue plan is a perfect solution for:
- Individuals with a pre-existing condition and deemed “uninsurable”
- Individuals who can’t afford a major medical plan and need basic coverage
- Individuals who exhausted their COBRA benefits and do not have other options
- Individuals seeking inexpensive “creditable coverage” to avoid a break in coverage while between jobs
Homeland Guaranteed-Issue Health Plans
Homeland Health Plans offers the best guaranteed-issue health plans on the market today. Their plans are all HIPAA Compliant and considered “creditable coverage”, which means pre-existing conditions are covered if there is no break in coverage for longer than 63 days and pre-existing conditions will also be covered (without a waiting period) if you later join a traditional employer plan. Homeland Health Plans utilize America’s largest PPO network (Multiplan), with over 500,000 providers, offers impressive savings when network providers are used. To search for physicians and hospitals in the Multiplan network, use the Multplan Provider Finder.
Guaranteed-Issue Plan Benefits
With no deductibles or co-insurance to satisfy, Homeland guaranteed-issue plans provide you with first dollar coverage. Mini-meds typically offer negotiated discounts through a PPO, but can be used at any provider — see whoever you like, or enjoy greater discounts in-network. For more detailed plan descriptions and benefits information, visit the Homeland website.
Plan Benefits include:
- Doctor & Chiropractic Visits
- Daily Hospital Confinement
- Surgical Benefits (inpatient or outpatient)
- Diagnostic, X-Ray & Lab Benefit (DXL)
- Wellness Care
- Accident Benefits
- Critical Illness Benefits
- Maternity Coverage
- Unlimited surgical benefits (100% of Medicare reimbursement schedule)
- No yearly or lifetime benefit cap
- Stable rates
- First dollar coverage (no copays)
- HIPAA Compliant
- Fully Insured
- 4 Plans to choose from – Bronze, Silver, Gold, Platinum, and Plus Plan
Inpatient Medical Expense Benefits:
- Daily Hospital Benefit*- Hospital benefit of $1,000 per day for up to 100 days per covered person, per calendar year. Unlimited re-admission.
- Hospital Admission Benefit* – An extra benefit for the first day of admission to the hospital ($2,000 per stay).
- Surgical Benefit* – Plan provides scheduled benefits for surgery per incident payable at 100% of Medicare reimbursement schedule (No annual maximum). Benefits are paid on inpatient or outpatient basis.
- Anesthesia Benefit* – Plan provides a 25% benefit (This benefit is calculated by multiplying the surgeons’ benefit times 25%).
Outpatient Medical Expense Benefits:
- Office visit* $100 paid per visit for up to seven visits per policy year per covered person.
- Surgical & anesthesia benefit* same as inpatient coverage.
- One (1) preventative test paid at $150 per year per covered person.
- Office visits can be used for chiropractic visits.
- Prescription discount* Prescription copays and discounts via Homeland Healthcare RX Card.
- Diagnostic tests, X-rays & lab testing* benefits are $400 for up to five visits per person per policy year. Benefits paid on inpatient of outpatient basis.
*Benefit amounts are based on the Health Max Plus Plan.
**This policy has a preexisting conditions limitation. Preexisting conditions are not covered until the policy has been in effect for more than 12 months. A preexisting condition is any condition you have now or had within a six month period prior to the effective date of coverage for each covered person.
Almost everyone qualifies for this health insurance policy; that’s the beauty of a guaranteed issue policy. People who usually don’t qualify for a health insurance policy because of pre-existing conditions (heart disease, etc.) will most likely qualify for a guaranteed issue health insurance policy.
Indivduals eligible for guaranteed-issue health plans:
- Individuals between 18-64
- Dependent children under age 19
- Unmarried dependent children with proof of full-time student status between the ages 19-25
- Individuals not in full-time service of the Armed Forces (military)
- Individuals not eligible for Medicare
- Individuals not receiving disability benefits or worker’s compensation
Homeland Health Plans accept and cover pre-existing conditions, but they are HIPPA credible and they will accept your HIPAA credits from your previous health coverage. When you obtain an Homeland Health plan, there is a 12 month wait for pre-existing conditions IF you haven’t had HIPAA credible coverage in the last 62 days. If you have, then the waiting period is reduced by the amount of months you had coverage, as long as the coverage didn’t have any gaps longer than 62 days.
Let’s say you had coverage through Blue Cross and Blue Shield from your previous employer. You were insured for 3 years with no gaps in coverage. You quit your job and decided to obtain Guaranteed Issue Health Insurance within 62 days. Your waiting period for pre-existing conditions would be completely eliminated because you had more than 12 months of HIPAA credible coverage at your previous employer. Now let’s say in the same scenario, you only held coverage for 6 months instead of 3 years. If you then converted to one of our plans, you would have a 6 month wait for pre-existing conditions assuming there was a gap of no longer than 62 days. This is due to the 6 months of HIPAA credit you obtained while at your last job.