Facts About Health Insurance And Pre-Existing Conditions That You Need To Know
Reality is sobering. You are discriminated against when qualifying for health insurance if you have a pre existing condition. If you’ve even remotely looked into this already, you know that indeed, it is a fact.
You’ll cost them more money than everyone else and that’s why insurance companies don’t want to cover individuals with a pre-existing condition. Considering that a pre-existing condition can include diabetes, cancer, heart disease, obesity, etc., it can be with you long-term or chronically for the rest of your life. Insurers are in business to generate revenue. They’re not in business to lose revenue. You will most likely get the same results when searching for coverage through various major medical insurance companies. Being declined is probable because underwriting is done in a similar fashion among all the insurers. But getting around it is within reach with the following available options.
1) If you are currently employed and your employer offers health insurance, you obviously have coverage through them which is an employer-sponsored group plan. All employees are covered in that group and can’t exclude you. So in this scenario, you are covered.
2) COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) – You and your family can continue to participate in your employer’s group health benefit plan if you lose your job; however, at your own expense for 18 to 36 months. It will definitely cost you more than what you were paying while employed; but your preexisting condition will be covered.
3) Guaranteed issue health insurance coverage for those with a pre existing condition or who are considered uninsurable is available out there. But, unlike a major medical plan, it’s actually a limited medical plan. That simply means you’ll have coverage up to a certain dollar limit for specific benefits. What ever is beyond that amount rests upon you. But, depending on which of these guaranteed plans you pick, you’ll find that they cover a pretty decent percentage or amount of the Medicare Reimbursement Schedule. Lots of other health benefits come with it too.
With a preexisting condition, you want to make sure that you’re covered through a guaranteed issue health plan that’s HIPAA-compliant because as long as you’ve had continuous (a maximum of a 63-day break) creditable coverage (individual, group, managed care, standard indemnity, COBRA) for at least 12 months before applying, you’ll be covered immediately. If not, your preexisting condition will have a 12-month exclusion or waiting period and then after that, you will be covered. At least you’ll know that it’ll be eventually covered and you won’t be declined. Again, there are many other benefits that you will get as well. You’ll be amazed.
4) Finally, state-guaranteed subsidized health insurance coverage is something that most of us have no awareness about. That comes as no surprise because for obvious financial reasons, states do not spend money on advertisement for it. HIPAA-eligibility is a requirement (see above) for this in some states unfortunately. I’ll preface by saying that it is specifically designed for people who are uninsurable which means they can not qualify for private health insurance. It is not designed for those who can not afford to pay for health insurance. It’s usually more expensive than private coverage for individuals with no health issues. Unlike commonly in an individual/family policy, the lifetime maximum benefit is lower; about $1 to $2 million. Some states require that you must be a resident of that state for a minimum amount of time before you are eligible; it varies. However, HIPAA-eligible individuals are not subject to state residency requirements.
A high-deductible health insurance plan is what I would recommend that you obtain if you or a family member have not developed a pre existing condition yet and are still healthy. In the future, if a pre-existing condition does develop, that coverage will already be established and your premium can not be raised as a result of it. Plus, it is guaranteed renewable which means it can not be canceled unless payments are missed.
Overall, for your pre-existing condition, you should be able to find some kind of health insurance plan, unless you are severely broke. Even in that case, there should be some kind of low income (or no income these days) Medicare program in your state. Maybe someone that you’re close to has good health insurance. Look into what you can legally do to become eligible under another person’s health insurance plan. Try it and see.
Nadine House is a licensed health insurance agent centered on helping people to make mindful decisions regarding their health care needs. To find out what is available for you and your family, visit: http://www.HealthInsuranceCoverageInfo.com
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