Considerations, Group Medical Expense Insurance and Connection Medical Insurance

If your work has given you insurance for major medical expenses; It is extremely important that you consider some very important points that you have to know and here we explain them to you.

What happens to my health insurance if I leave my job at that company?

In the simplest of situations, the only thing that will happen is that you will lose the benefit.

But if you want to stay insured on your own. You do not have a guarantee that the insurer will continue to ensure you and keep the conditions. Since this depends on some factors.

It is important to clarify some terms used in this case: SENIORITY, WAITING PERIODS, and PRE-EXISTENCES.

SENIORITY: In major medical expenses, seniority is the time that the insured has been covered continuously.  

And SENIORITY is important because the WAITING PERIODS are going to be defined from it, that is to say; the time that must elapse before an illness can be covered by the insurer. Since there are certain diseases in which the insurance companies stipulate that a certain time must elapse from the time you contract the insurance so that they can begin to be paid.

PRE-EXISTENCES: It is one or there are conditions that were diagnosed before contracting the health insurance and therefore are exclusions, and it means that all expenses generated by that condition may not be reimbursed by the insurance company, and depending on the condition may cause them to exclude other diseases that they consider medically related. Also in many cases, the company will decide whether or not to insure the applicant. The mere fact of already presenting symptoms or manifestation is already a condition even if it has not been treated.

What happens when an illness is detected while you work for the company that gives you the benefit?

Through your employer's policy that you have as a benefit, claims for this disease will be covered without any problem. But if you leave your job and consequently the benefit, under certain conditions you will lose the coverage benefits in the new plan. In addition, it will be necessary to consider that companies, when contracting their insurance, generally limit their coverage, in order to also reduce its cost, and a situation that can frequently occur is that the Insured amount of the policy is small. If the sum insured is exhausted, subsequent costs must be covered by you. 

There are policies that offer you to continue your insurance; since a clause is handled that most of the time is contracted with an extra cost for the CONVERSION TO INDIVIDUAL pattern. You will rarely find this benefit since it will have an extra cost for your employer and it will work when you leave the company, so the company seldom sees the utility of hiring you.   

But if when leaving the company, the policy in which you were insured has the benefit of CONVERSION TO INDIVIDUAL. Then, you will keep the seniority that you acquired from the contracting of this policy, and your insurance will be given continuity now in an individual coverage without loss of benefits. With this policy, you are guaranteed continuity in the payment of claims that come from the collective Policy, according to the conversion conditions that have been stipulated.

On the other hand, if when you leave your company you are still healthy, you can take out an individual policy with the insurer that suits you best within the next 30 days after your insurance is canceled. But they will submit you to a decision or selection process in which they will assess whether they accept you or not. Therefore, it is important to contract it before you have an illness since if you want to do it later, it will be the exclusion and in many cases, it will cause you to not be accepted in health insurance. (This will depend on the condition)

A solution to the above is the contracting of a Continuity of Medical Expenses or Connection Insurance. This is complementary coverage to your medical insurance so that in the event that you leave the company for any reason and in any state of health, this insurance offers you the benefit of offering you insurance for major medical expenses.

Another benefit of this policy is that it also acts as an extension of the insured sum provided by your company so that if the illness you have exceeds the amount of the insured sum offered by the benefit, you can use your policy. of connection.

By official rules, you cannot be charged a double deductible for illness, this means that, if you already paid a deductible when you started the claim in your group medical expenses policy when the connection policy enters, you are not charged a second deductible, only the payments for your illness will continue to be made to you, I repeat: it does not matter that the first claim was with another company.

These policies are much cheaper than an individual policy, but they offer you the same benefits, that is, you can put it together according to your needs. But when requesting the conversion of the policy due to loss of work benefit, the price will now be that corresponding to a Full Medical Expenses insurance.