Finding Health Insurance With a Pre- Existing Medical Condition

Health Insurance and Pre-existing Conditions

     In the past, people avoided seeking medical treatment because they had no health insurance, or because they were afraid a doctor visit would appear on their medical records. Finding health insurance with a pre- existing condition can be a challenge. I understand as this year a member of my family was denied health insurance because of a medical condition. My story is not uncommon.
     An acquaintance recently confided in me, “My husband and I are losing our insurance policy through Cobra. We have applied for coverage at two different insurance companies, and we were rejected by both of them. It is because of my pre-existing condition.”
Because of health care reform, there are increasing options in obtaining health care coverage, for adults with existing medical conditions. Currently there are new pre- existing condition insurance plans (PCIP) for consumers with pre-existing medical conditions in every state. Visit pcip.gov for more information. PCIP allows adults with pre-existing medical conditions to obtain a wide range of insurance benefits including hospitalization, doctor, specialist visits, and prescription drug coverage. Health care coverage begins immediately. There are no waiting periods or exclusions for medical treatment of pre-existing conditions. PCIP is available to adults who have been uninsured for at least six months. In addition, applicants require an application denial letter, from an insurance company in the past year. PCIP insurance plans are available to everyone, regardless of income. Insurance premiums are determined by age and location.
Another option for people with existing medical conditions and no health care insurance is joining a high risk insurance pool. Currently 34 states have some form of high risk health insurance. High risk insurance pools allow people with medical problems, who are usually declined health insurance coverage, to receive some insurance benefits. The drawbacks of participation in the risk pool are high premiums, limitations on benefits, and long waiting periods to obtain coverage. There are also limits regarding residency requirements and the number of participants in the high- risk pool.

With few options what can adults do who have an existing medical problem? One possibility is to create a small business and enroll in a group health insurance plan. In many states, people with pre-existing conditions are starting small businesses as a source if extra income and for group health care insurance. Most states have laws that offer group policies with guarantee issue to small businesses with as few as 1 or 2 members and as many as 50. In California, a business with two or more people is eligible for a group health care policy. The benefits of group policies over individual health care plans are that they are guaranteed to issue by law regardless of any pre-existing medical condition. In addition, there are no time limits on insurance coverage.
Thanks to health care reform, consumers with pre- existing medical conditions have better access to health care insurance. There are new regulations in almost every state regarding health insurance for people with pre-existing medical conditions. Most local insurance agents are extremely knowledgeable regarding the new health care reform laws. Consumers who have pre- existing medical problems and need health care insurance should contact their local insurance agent to determine if they are eligible for benefits.
References
http://naschip.org/states_pools.htm
http://Pcip.gov