Understand the rules and regulations regarding health insurance in Michigan before you buy a policy so that you know what the insurance company is and is not allowed to do.
Michigan laws on health insurance provide very specific rules and regulations on group health insurance as well as individual health policies. These laws are enacted to provide a way for you to obtain health insurance. However, while some of the laws in Michigan are designed to benefit you, some laws are in place to benefit insurance companies. Make sure that you understand what insurers can and cannot do in your state.
Discrimination In Group Health Insurance
Group health insurance policies in Michigan cannot discriminate against you by denying your coverage based on your health status. However, your employer can limit or restrict coverage based on your employment status and number of hours worked. This means that if you work less than 30 hours a week, for example, your employer could deny you health insurance coverage. This rule must be universal for all employees.
Denial of Coverage
Health insurance companies in Michigan are allowed to turn you down for health coverage if you are buying an individual health insurance policy. This differs from group health insurance where you cannot be turned down due to health reasons. However, unlike a group plan, your individual plan is not tied to your employer. Thus, if you lose your job, you won't lose your health insurance. Blue Cross/Blue Shield is the exception to this rule. In Michigan, Blue Cross/Blue Shield must sell a guaranteed issue policy. This means that they must sell an individual health insurance policy to any resident in the state regardless of their health status.
Child Coverage
Children are automatically covered under your heath insurance if they are newborns. This coverage lasts for 31 days. After this time, you must amend the policy to reflect the new addition to your family and pay the premiums for the additional subscriber (the child). If you do not, your child will not be covered under the policy after 31 days.
Disabled Children
Disabled children are allowed to remain on their parent's health insurance policy for as long as they are unable to care for themselves. The parents must prove that their child is primarily dependent on them for care as well as financially dependent. Finally, the parents must provide this proof within 31 days of the disabled child reaching the maximum age limit for the coverage of dependent children (which will be specified in the policy).
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