Health Insurance Mastery Practice Exam

What feature allows an insured to obtain health insurance without a medical exam based on prior coverage?

1. Waiver of premium

2. Guaranteed issue

3. Coordination of benefits

4. Continuity of care

The correct answer is: Guaranteed issue

The feature that allows an insured to obtain health insurance without a medical exam based on prior coverage is guaranteed issue. This concept is essential in health insurance as it ensures that individuals, regardless of their health status or pre-existing conditions, can obtain coverage when they transition from one plan to another or during specific enrollment periods. It serves to protect those who might otherwise face barriers to obtaining insurance, allowing them to maintain continuous coverage without the burdens of medical underwriting. In many instances, guaranteed issue is particularly relevant during open enrollment periods where individuals can enroll in a new plan without restrictions, ensuring that those who have had previous coverage, such as through an employer or under the ACA (Affordable Care Act), can avoid the hassle and potential denial of coverage that typically comes with a medical exam or health screening. Other options may relate to coverage or the administration of benefits, but they do not directly facilitate the acquisition of insurance without the need for a medical exam. For instance, a waiver of premium pertains to the situation where the policyholder does not have to pay premiums during a time of disability. Coordination of benefits refers to the process of determining the order of payment when an insured has multiple coverages, while continuity of care ensures that patients can continue with their current healthcare providers during transitions