Practice Quiz

Health and Life Insurance

Category - HMOs

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Fred has a heart condition that has prevented him from obtaining traditional insurance. If he wants to purchase HMO coverage, what should he do?
  1. Apply for the HMO during open enrollment
  2. Apply for an HMO anytime
  3. Not mention his heart condition on the application
  4. Falsify his medical records to eliminate notes about his problem
Explanation
Answer: A - Fred should apply for the HMO during an open enrollment period. HMOs are prevented from denying a member for pre-existing conditions during open enrollment. When an HMO offers open enrollment they usually do so for a period of 30 days as mandated by state law.. During this time HMOs cannot reject an applicant for health reasons. Note this is only the case during times of open enrollment. Other times, an HMO can deny coverage for pre-existing conditions.
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