Tonik is pretty different from the other plans on the California health insurance market when it comes to the application and enrollment process.  Tonik health is "simplified issue" which is just a very technical way of saying that "you're either in or you're out".  One complaint people have with the health application and underwriting process of other plans is that it takes too long.  Most of the time (especially with the advent of online apps) this is due to the request of medical records by the carrier. 

How medical records are treated with Tonik health applications

After reviewing the health history questionnaire, California health insurance carriers can and do request medical records from doctors or providers if they want to look more deeply into a given condition for the standard health insurance application.  Tonik is different.  If the application is "clean" meaning that there isn't much going on health-wise, the computer system will automatically approve the application.  This is called auto-adjudication.  Conversely, the computer can automatically decline coverage if there certain issues are listed.  If the health history information listed on the application is in the "grey" area, the application cannot be processed.  Officially, this is a decline but it does not mean the applicant will be unable to qualify for other coverage.

What if the applicant is declined coverage by Tonik

If a Tonik application is declined coverage, we recommend to apply for one of Anthem Blue Cross's equivalent plans.  With the standard plans, the carrier is able to request records and get answers to their questions.  They are not able to do this with Tonik.  There are many conditions and/or treatments that can either be serious or benign depending on what the doctor said in the records.  Any item that appears open-ended is viewed conservatively by the California health insurance carrier.  They assume worst case as they do not have the full picture.

Complete the Tonik application accurately and fully

If information is left off the Tonik health application, it can cause the coverage to be rescinded at a later date.  You want to make sure that all pertinent health history information is listed in the correct section.  Do not assume that a given issue is no longer an issue.  Provide the information and let the carrier make that decision.  It does you no good to get approved for a plan only to have it rescinded later when you really need the coverage because pre-existing conditions and/or treatment was not listed on the app.  Everyone has medical history.  People with prior issues qualify for coverage every day.  The carrier is primarily concerned with recent and ongoing medical situations or serious situations in the past.  Provide all information and let them make a decision.  There's nothing worse than to have coverage rescinded.  Handle the application correctly up front to insure your coverage.  As for dates and doctor information, research and provide the information as best possible.  The carrier can request medical records if they want to look deeper into a given situation. 

Other important concepts to help you understand your California health insurance quote are:
 

Quote Tonik health insurance
Individual health insurance underwriting
Enrolling for Individual health coverage in California
Download the health application or apply online
What can delay your individual health application
Options for people who do not qualify


To run your instant health insurance:

California Individual Family health insurance quote
California group health insurance quote