Guaranteed-issue health insurance is coverage that can be purchased by a consumer regardless of their health conditions, age or other medical factors. This health insurance coverage is guaranteed to be issued and guaranteed to be renewed. Of course, the policyholder must pay the premiums in order to keep the policy and to be able to renew the policy.

The most common guaranteed-issue health insurance plans are employer-sponsored group policies (with two to 50 employees), which are currently required to accept a small group without considering the health status of the persons who would be covered. In addition, most group plans allow employees and their dependents to enroll in the employer-sponsored group plan without any medical questions or medical evaluation by the insurer. Many states have their own rules regarding guaranteed-issue health insurance coverage. Some states require insurers also provide guaranteed issue coverage to a sole proprietor with only themselves as an employee.

Individual policies are not required to be guaranteed issue currently. To combat the problem of insuring high-risk individuals, most states now have high-risk pools that insure those that insurers have turned down. They are guaranteed to be accepted into these pools, although they may have to show they were rejected by other insurers and some waiting periods may be applied.

Unlike small group health insurance, insurers do not have to offer a guaranteed-issue plan to a large employer group. The insurer examines the claims history of the group and decides to accept or reject the entire group. If they do accept the group, premiums are based on the claims history and any applicable state requirements. Insurers cannot accept the group and then exclude certain employees because of their medical history. Under federal law, group insurance contracts can be renewed by the employer on an annual basis as long as the premiums are paid and they have complied with the contract.

The Patient Protection and Affordable Care Act of 2010 put sweeping chances in place that require insurers to provide guaranteed-issue health insurance coverage. They must do so, regardless of the preexisting conditions or other medical conditions of the consumer. This applies not only to group coverage, as it currently does, but also to individual health insurance plans. The provisions of the legislation regarding guaranteed-issue policies will not take place until 2014. At this time health insurance pools will be established and citizens must either buy health insurance or pay a tax penalty.

Guaranteed-issue plans will certainly be easier to come by when the new laws take effect in 2014. Currently, to get guaranteed-issue policies a consumer's best bets are group plans or state high-risk pools.