Small business forms the backbone of our economy. It is rather interesting then to realize what a raw deal small business gets. A classic example is the brutally difficult time a self-employed person with a pre-existing condition has trying to get health insurance. If you are lucky, some states have a concept known as a group of one that can help.
Health insurance companies are in business to make money. People seem to forget this. I am not standing up for these companies. They do some pretty brutal things in my opinion, but people need to remember they are businesses. As businesses, they don?t want to ensure someone they know is going to cost them a bundle. No business wants a customer like that. Self-employed individuals with pre-existing conditions are, unfortunately, just that.
The ?group of one? health insurance option is a real winner. It is based on the idea that a person cannot be denied coverage because of a pre-existing condition under a group policy. For instance, a person with a heart condition who works for Google cannot be denied coverage under their plan. In states that allow it, you can actually purchase group plans for your self-employed business and then join your own group. It sounds strange, but it works.
Are there any downsides to this strategy? Yes, there are a few. First, the group of one concept is so despised by insurance companies that a law has to be passed before they will submit to it. So far, only 12 states have it – Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Michigan, Mississippi, New Hampshire, North Carolina, Rhode Island and Vermont. If you live in another state, the group of one strategy cannot be used.
The second problem is the timing of coverage. While the 12 states above will allow the group of one concept, the coverage can be limited at first. A not uncommon regulation is the insurance company can avoid coverage on the pre-existing condition for the first six months of the policy. For individuals with ongoing health problems, this is a huge problem.
Is group of one health insurance the answer for individuals seeking health insurance with pre-existing conditions? Yes, if you live in one of the 12 golden states that allow it.