Health Insurance and Pre-existing Conditions

Health Insurance and Pre-existing Conditions

Obtaining health coverage with pre-existing conditions can present some challenges. However, just because pre-existing conditions exist, it is still possible for an individual to get health insurance coverage, even if they don’t get as many options as those without any pre-existing health concerns. This article is meant to help you overcome the mystery of what qualifies versus what disqualifies you for health insurance coverage. So even if you have a pre-existing condition you can find suitable health coverage.

Characterizations of a pre-existing condition
A pre-existing health condition could include the following instances that an individual has prior to applying for health insurance coverage. Keep in mind the definition of “pre-existing condition” can vary in different states or health insurance providers:

  • A disability
  • An illness
  • A sustained injury

Health Insurance and the Affordable Care Act
The 2014 Affordable Care Act dictates that all individuals have a right to health insurance, pre-existing condition or not. However, insurance companies may still try to put up obstacles when it comes to pre-existing conditions and realistic health insurance coverage.

Today, Americans with pre-existing health conditions have an easier time gaining health care because insurance companies (i.e., Blue Shield, Aetna, Cigna, etc.) cannot deny coverage based on a pre-existing health based on a lengthy list of deniable conditions.

Roadblocks to health insurance coverage
Prior to the introduction of the Affordable Care Act (ACA), insurance companies listed over 400 illnesses and conditions that could lead to a denial of claim. That list included diseases like muscular dystrophy, heart disease, mental illness, hepatitis, cancer, and in some cases, even pregnancy.

Today, Americans have a right to coverage with pre-existing conditions, as per the Affordable Care Act. However, limitations on premiums still exist. For instance, an individual with heart disease may not be denied health coverage, but may be charged a higher insurance rate. Keep in mind, the ACA limit insurance company premiums, in addition to scrapping limits when it comes to lifetime benefits on individuals with life-threatening illnesses (i.e., cancer).

If you are denied health insurance coverage due to a pre-existing condition consider the
Pre-Existing Condition Insurance Plan (or PCIP), specifically created for those with pre-existing condition previously denied by major insurance or private insurance companies in the U.S.