A pre-existing condition is any medical condition or issue a person has prior to applying for and obtaining a healthcare insurance policy.
Many individuals believe this is one of the biggest holes in the U.S. healthcare system.
Examples of a pre-existing condition include cancer, diabetes, pregnancy, and even depression.
If you have been medically documented as having any of these conditions, health insurers are less likely to accept you as a candidate for a policy, or charge you much higher premiums than the average person.
The good news is you are not necessarily out of luck.
Typically, when you obtain a healthcare policy with a pre-existing condition, your insurer will force you to undergo a waiting period prior to them paying insurance claims resulting from your pre-existing condition.
For example, a 12-18 month waiting period is not uncommon. It protects insurance companies from issuing a policy to an individual who purchased it with the sole intent of receiving immediate medical care due their pre-existing condition.
It’s important to remember that insurance companies, like any other company, are out there to make money.
They accomplish this by pooling money together from a large number of people and trying to avoid paying claims. A pre-existing condition goes against this principle because there is almost a guarantee the insurer will pay claims on your policy. And the claims will likely outweigh the premium you’re being charged.
Depending on where you live in, you may be able to join a high-risk insurance program funded by admitted carriers selling insurance products within your state.
High-risk programs are designed specifically for those who are likely to have claims. There are high-risk programs for homeowner’s insurance and auto insurance policies as well.
You will need to contact your state department of insurance to determine if your state has one of these programs.
Additionally, the Health Insurance Portability and Accountability Act, or HIPAA, serves to ensure an individual cannot be turned down for insurance when switching jobs when a pre-existing condition is present.
This law is often misunderstood to mean that insurers cannot deny coverage for those who are currently uninsured. This is not the case. If you are currently uninsured, HIPAA will do you no favors.
I recommend contacting an independent insurance agent to determine if you can obtain coverage for with your pre-existing condition.
He or she will potentially be able to offer you multiple quotes in order to find the best available health coverage at the lowest rate.