Reader’s Question:

I’d like to know if I have any specific federal and state protections when it comes to my health insurance policy?

David

Gilbert, AZ

Remember that whatever your health insurance policy is, you always have state and federal rights and protections. These safeguards are determined by your health insurance type and state. I cannot give you everything here but I can give you and overview. You can always check for some resources online.

Under the HIPAA law, your insurance company cannot drop you from coverage in case you develop an illness or medical condition as long as you pay your premiums. The state also can mandate that the elements of your plan, like the types of prescription drugs covered, should not be changed in the middle of a covered year. Now if you have an individual insurance which you purchased on your own, you are always protected by the state law. Many states have a patient’s bill of rights and you always have the privilege to check this yourself. For employer-provided health insurance coverage though, you are always covered by the federal Employee Retirement Income Security Act or ERISA. It is in this law where guidelines are set for the health insurance benefits plans of private employees. Among its mandates include that you should be informed about your health insurance plan’s provisions and information on how to file a claim, how to appeal a denied claim, and the special process for reviewing appeals.

These are just a few though, so you can check out other state provisions from your own.