Health Insurance With a Pre-Existing Condition

When you have a pre-existing medical condition and you have no insurance it can be a very overwhelming feeling. The stress of figuring out how to get insurance to take care of your condition and address basic medical needs can make you sick in itself. All hope is not lost for getting health insurance when you have a pre-existing condition, it may just take a little more know how and work to get the coverage you need and deserve.

The amount of coverage that you can get with a pre-existing medical condition varies from state to state. If you have a job that offers insurance it is illegal for them to refuse to provide you with insurance because of your condition. Every employee has the same right to health insurance regardless of their medical situation.

Generally, health insurance companies consider a pre-existing condition something that you are already taking medicine or something that you have already received treatment for in the past. Things like pregnancy, AIDS, high blood pressure, stroke and diabetes are all considered pre-existing conditions. Every insurance company has its own policies regarding pre-existing conditions and new members. Some health insurance companies have waiting periods that must be exercised for certain conditions and others will cover you, but they won’t cover the pre-existing condition you have.

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Every state has a policy that ensures individuals with pre-existing conditions can obtain health insurance. Some states have a high risk pool that covers part of the cost of health insurance through state funded appropriations. Other states offer guaranteed insurance that is basic or standard. The easiest way to determine what programs your state has and whether or not you are eligible for these programs is to contact your state’s department of insurance. You can locate this information of the Internet or through the National Association of Insurance Commissioners.

In general most HMOs will cover a patient regardless of a pre-existing condition, but they will utilize the previously mentioned waiting period before that condition will be covered under the plan. That means that you can use the plan for other medical needs, but needs related to the pre-existing condition would have to be paid out of pocket until the waiting period expires. This means that you may have to wait a period of six months to a year from recovery before you can be treated under the plan.

Some health insurance companies will cover you immediately when you have a pre-existing condition, but the cost of your premium and possibly your deductible will be greater. The company will evaluate your condition and base your rates on what they feel is fair based on how much they think you will need to use your coverage. This is obviously not the ideal way to get coverage, but if it helps defer some of your out of pocket expenses, it may be worth the increased cost.

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