QUESTION

Is an insurer allowed to ask me about my health history?

Individuals with no coverage | Navigating Health Insurance Marketplace Options Comparing Plans: Benefits and Costs Coverage Outside the Marketplace
ANSWER

In general, if a plan offers the Affordable Care Act’s protections, an insurer should not require you to answer questions about your health history when you are applying for a plan. A navigator or broker may ask about your health history to guide you to the most appropriate plan offerings, and no plan offered on the Affordable Care Act’s marketplace through HealthCare.gov will require you to answer such questions.

If you are purchasing a plan outside of the marketplace and an application requires you to answer questions about specific health conditions, or asks you to check a box to release your medical records, you may be applying for a plan that will charge you more or limit your coverage based on pre-existing health conditions. These plans do not provide the Affordable Care Act’s protections guaranteeing coverage to people with preexisting conditions and setting limits on out-of-pocket costs. Ask a reputable broker (you can find one by contacting your Department of Insurance) to look at the plan details and proceed with caution, especially if purchasing a plan online or over the phone.

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