Guaranteed Acceptance Health Insurance: An Alternative for Some Consumers

For consumers who have pre-existing medical conditions which prevent them from obtaining traditional health insurance, a number of guaranteed acceptance health insurance plans are available. These differ from standard health insurance plans in several ways; most importantly, most of these guaranteed plans feature a strict limit on benefits payable during any calendar year. Known as indemnity plans, they provide many of the same coverage options as the standard plans, but once you have met your yearly maximum benefit amount, the remaining costs of your medical procedures are your own responsibility.

These indemnity plans often limit doctor visits to a predetermined number each year, and may cover only a specified number of days in hospital or a limited number of emergency room visits. For instance, a plan that pays $500 per day for hospital stays may limit the number of days to five; after five days in the hospital, the plan will not pay any further benefits for hospital stays during that year. Additionally, the plan may also feature a maximum annual benefit, which limits absolutely the insurer’s liability to a pre-set amount, usually between $1,000 and $10,000 per year. Some indemnity plans require a waiting period before pre-existing conditions are covered; others cover all conditions to a specific level from the first day of coverage. Many of these indemnity plans feature insurable benefits; this indicates that certain benefits are covered in the same way that standard insurance does. Typical insurable benefits include prescription medication coverage and routine doctor’s visits.

While traditional insurance plans offer more comprehensive coverage and are preferable in most cases, guaranteed acceptance health insurance is a feasible alternative in cases where pre-existing conditions prevent consumers from obtaining standard health care insurance. If standard creditable coverage policies are available, they will almost always provide a higher level of security and coverage and a wider range of services than these guaranteed indemnity plans. However, for consumers who cannot obtain traditional health care coverage through the usual means, guaranteed acceptance health insurance can provide a reasonable alternative and offers a significant improvement over discount plans or, worse yet, no health insurance at all.