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Health Insurance Requirements

General health insurance covers the widest variety of health care expenses, and it can be grouped into several segments, each with its own requirements. While all policies within a certain type have similarities, each policy is still slightly different from the next. That's why it's so hard to come up with a hard and fast list of requirements for every policy. There are four ways to get health coverage in the US; you can apply for government sponsored insurance, you can get coverage through your employer, or enroll in a group policy, or you can pay for insurance privately. This guide will cover each type of general health insurance, and briefly touch on the requirements for each.

Government-sponsored health insurance programs are meant to provide cover for socioeconomic groups that may not otherwise be able to get insurance. These programs tend to be more basic in nature, meaning that you may not get covered for certain procedures and tests. However, they are by far the cheapest option. Government run programs exist at federal and state levels, including Medicare (covering health care for seniors who paid into Social Security), and Medicaid (health care for people in lower income levels). Medicaid is run by the federal government, but each state has its own eligibility requirements. Some states (as of now, 31 out of 50) have state risk pools, which are programs that provide insurance for people with pre-existing conditions that would otherwise get their coverage denied. There are also state children's health insurance programs, which are collaborations between the state and federal governments, providing insurance for children whose parents make too much to qualify for Medicaid, but not enough to pay medical bills.

Employer-sponsored health insurance plans have your employer paying your medical costs as part of a benefits package. This coverage is automatically available to you, regardless of any pre-existing medical issues you have, and you will not be dropped if you become ill. Your coverage can be limited, but only for a maximum of 18 months. Employer-sponsored coverage often includes vision and dental benefits, but usually comes with a limited choice in physicians. Most employer-sponsored insurance can be kept for up to three years after leaving a job.

Group insurance plans cover members of small groups. This type of coverage is ideal for smaller businesses that cannot afford to have a full-fledged employer-sponsored program, and it is also used by charities and social/community groups. These policies typically come with lower premiums and less strict eligibility requirements, but coverage can be fairly limited.

Individual insurance is a policy that a person can buy themselves, from a private insurer. While these policies offer the highest level of choice in health care, the eligibility requirements are much more strict. With an individual policy, the provider takes into account your health history, your age, your location, and what kind of health risks you face from day to day. Lifestyle factors, such as smoking and obesity, can also affect your eligibility for individual insurance. If a person is healthy and young, premiums are low, but can increase as a person ages and perhaps gets sicker.