Back
to Top

University of Chicago Study on Pre-Existing Conditions

Insurance for Pre-existing Condition: Ensuring Savings On Health Care

A preexisting condition relates to a medical issue which was present prior to an individual obtaining a health insurance policy. The term preexisting condition has received a bad reputation as it may prevent you from obtaining health insurance coverage or make you pay a costly premium when health insurance coverage is obtained. Some of the more common preexisting condition includes pregnancy, obesity, arthritis, diabetes, depression and fibromyalgia.

Thousands of individuals today have been declined health insurance because of a preexisting condition. These individuals are facing serious health issues like heart disease, heart attack, diabetes, cancer, stroke, liver disease, AIDS, pregnancy, depression and kidney disease.
It is very difficult for anyone to get health insurance for preexisting condition. Any preexisting condition will trigger a red flag with health insurance company and cause and individual to be declined for health insurance coverage. This is because the health insurer is in the business of making money. Even being overweight can cause you to be declined for health insurance coverage even if you do not have any medical issues or problems at all.

Thankfully, not all insurance companies are the same. While some health insurers will penalize (through higher health insurance premiums) or refuse to cover your medical condition, some insurance companies will have a more lenient approach to preexisting conditions, although there may be certain restrictions.

Most health insurance companies will require the newly insured to undergo a preexisting exclusion period. This is a waiting period before having their preexisting conditions covered under the health insurance policy. The typical preexisting exclusion period for individual health insurance policies is a waiting period of 12-18 months before they will pay medical bills related to preexisting conditions.

There are also certain protections given to individuals with preexisting medical conditions. Under the Health Insurance Portability and Accountability Act (HIPAA), individuals who have previously been insured under a group health insurance plan and are obtaining a new type of health insurance may be able to have their preexisting conditions covered so long as they meet certain criteria. However, the HIPAA relates to individuals who have been previously insured under a group health plan and not an individual health insurance policy.

The HIPAA is useful to individuals who switched jobs and consequently, to another group health insurance policy. This will prevent an individual from having to pay for costly insurance due to a preexisting condition or having a hard time obtaining health insurance altogether.

Other health insurance alternatives are also available for those with preexisting conditions who are looking to obtain individual health cover. Most states have high risk insurance pools which provide coverage to individuals with preexisting conditions. The disadvantage with these high risk insurance pools is that they are very expensive as compared to other types of insurance. If you can afford it, this alternative is better than having no insurance at all.

You should carefully weigh the costs and benefits of health insurance especially if you have a preexisting condition. The additional costs in the form of more costly health insurance premiums are greatly justified as the risk are greater of foreseeable medical expenses. It is a fact that many people face severe financial problems because they have high medical bills and no health insurance.

Searching An Agent... Did you know...?