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The search for the right health insurance can be a frustrating process, but if you have a pre-existing condition, it can be even more challenging.
It all comes down to the fact that a person with a pre-existing condition is a higher risk, and therefore more expensive to insure. You may have been denied coverage entirely, or your coverage may be more costly than you would like.
If you’re having trouble finding insurance for pre-existing conditions, contact one of our local independent agents in the Trusted Choice® network. Because our agents have access to many different insurers, they can quickly browse offerings from different health insurance companies to find a policy that offers insurance for pre-existing conditions.
Facts About Pre-Existing Conditions
- Examples of a pre-existing condition include heart disease, high blood pressure and asthma
- 21% of people with pre-existing conditions are rejected or charged a higher premium for individual health insurance
- In 2014, the Affordable Health Care Act will make it illegal for insurance companies to deny or charge higher premiums because of pre-existing conditions
What Are My Options if I Have a Pre-Existing Condition?
If you have a health plan through your employer, insurance that covers pre-existing conditions will be easier to find. Group policies cannot deny coverage even if you have a history of serious medical conditions. Not everyone can receive employer-sponsored insurance, however. If you have to find individual health insurance with a pre-existing condition, it may be a difficult search.
Some insurance companies offer what is known as a CSD, or condition-specific deductible. This allows you to receive normal healthcare coverage with a normal deductible for everything except your specified condition. Your insurance for pre-existing conditions will have a separate deductible amount which is offered in amounts from $2,500 to $15,000 depending on providers. This may be a better option for you than having your specific condition completely excluded from a policy.
Consider contacting an independent agent who can help you understand how different plans will affect your pre-existing condition and which one is ultimately your best choice.
What Is a Pre-Existing Condition Insurance Plan (PCIP)?
If you’re denied health insurance due to a pre-existing condition and haven’t had coverage for at least 6 months, the pre-existing condition insurance plan is a federally funded plan that may help. This plan covers primary, specialty and hospital care as well as prescription drugs. Depending on where you live, program rates may vary.
At this time, the PCIP is not accepting new applicants. Typically, those enrolled through this program have expensive medical needs and the program receives a limited amount of government funds. The program ceased taking new applications in 2013 in order to make sure that over 100,000 people continue to receive benefits through that calendar year.
While it’s possible that this federal insurance plan may re-open in the future, if you need insurance coverage now, there are several things you can do. Read on to find some tips on getting insurance for your pre-existing condition.
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Tips for Finding Insurance for Pre-Existing Conditions
- Start a business: If you run your own business, in some states, insurance companies will consider you a group. Through group insurance plans, you cannot be denied based on pre-existing conditions (or the denial may only last a short period of time). Check your state for specific laws.
- Use COBRA: If you’ve lost your job, consider investing in COBRA. While it is expensive, it will buy you time and keep you insured while you search for new coverage. Typical coverage is up to 18 months but don’t let much time pass between COBRA coverage and your new policy. After 63 days of being uninsured, you have a significant gap in coverage which can make it much more challenging to get a new policy.
- Join a high risk pool: Check to see if your state has a high risk pool, which is for those who have difficulty finding affordable insurance due to severe health conditions. Rates will typically be higher, but it may be worth it to ensure that you have the healthcare coverage you need.
- Apply for government aid: Programs such as Medicaid may be able to offer relief to low and moderate income families
The Future of Insurance and Pre-Existing Conditions
As of 2014, people who seek insurance for pre-existing conditions will be able to find affordable coverage for the first time. With the passage of the Affordable Care Act, it will be illegal for insurance companies to charge higher premiums for pre-existing condition insurance plans, or to deny coverage. Insurance companies will not be allowed to exclude coverage for a specific condition and cannot set a dollar limit on the amount of benefits provided.
To get a complete understanding of your health care options, contact one of our independent agents in the Trusted Choice network who specializes in health insurance. You can gain more control over your situation by exploring and leveraging all the options available.
Our agents will work one on one with you to help you find the right insurance for your pre-existing condition that fits your specific needs.
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