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Health Insurance Consumer Rights

The government provides important protections for consumers via state and national laws. For current information on health insurance laws, visit the Department of Insurance website in your state.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) offers particular consumer rights that you need to be aware of. It was enacted to improve portability and continuity of health insurance and simplify the administration of health insurance. Specifically, the law provides protection to consumers who purchase health coverage and then subsequently become sick or injured. These people are guaranteed to be able to continue their health insurance without fear of being cancelled by the insurance provider.

Guaranteed Renewability

In some cases federal and state laws and regulations, such as HIPAA, may limit a health insurance company's ability to cancel your insurance if you continue pay the premiums.

Limitation on Exclusions

A pre-existing condition must be covered after 12 months of health insurance coverage in most states. Additionally, if the insured individual has not been uninsured, there cannot be any coverage exclusions.

Guaranteed Issue

A small business owner who applies for group health insurance cannot be rejected by an insurance carrier that offers small group insurance because of the medical history of the group or any other issues.


Similarly, a group health insurance provider also cannot apply different requirements or fees to members of the group. So, the group health insurance has to cover everyone in the group at the same level and at the same rate, regardless of their medical history or other factors.

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