Can You Get it?
If you have a pre-existing medical condition, your new health insurance policy may cover some or all of the expenses related to this illness.
However, not everyone with a pre-existing condition qualifies for coverage. To get approved for healthcare benefits, you need an individual plan purchased through the Health Insurance Marketplace under the Affordable Care Act (ACA).
What is a Pre-existing Condition?
A pre-existing medical condition is any one of the following:
Let’s have a closer look,
- A current illness or injury that you have now but was not diagnosed before your coverage began.
- A past illness, injury, or hospitalization for which you were treated in the 12 months before your enrollment date.
- An existing medical problem such as asthma, diabetes, obesity, etc., whether diagnosed by a physician and reported to an insurance company within 18 months of enrolling in new health care coverage with that condition.
What Cover Can You Get?
It is possible! Getting health insurance with pre-existing conditions can be tricky, but it’s not impossible.
Let me explain,
For example, you might qualify under one of the following circumstances:
You can get coverage for the following:
- A pre-existing condition that you have now but was not diagnosed before your coverage began.
- If it has been treated in 12 months before enrollment date with new health insurance, a past illness or injury has been treated.
- An existing medical problem such as asthma, diabetes, and obesity, whether diagnosed by a physician and reported to an insurance company within 18 months of enrolling in new health care coverage with that condition.
- If you have certain types of cancer (such as leukemia) or HIV/AIDS, there is no waiting period at all! You must be enrolled during open enrollment periods unless otherwise qualified. Full medical cover underwriting applies to new individual health insurance coverage for those with a pre-existing medical condition.
This type of underwriting applies to new individual health insurance plans for those with a pre-existing condition.
If you have had any of the following in the last 12 months, you may not be eligible for coverage:
Let me show you:
• You did not maintain continuous creditable coverage (COC) by having one day without COC during the previous 18 months
• Your spouse refuses to waive all spousal rights or release information needed to determine if there is a medical treatment plan available from your employer’s medical insurance program that would meet our standards, and it cannot be determined whether your employment prevents access because we are unable to obtain such access through an alternative source; or
• You failed to disclose material facts relating to your existing conditions when applying for previously-owned individual insurance.
Covering Chronic Condition
If you have a chronic condition and are not being treated, you may decline coverage.
The following conditions are considered chronic, meaning they do not resolve themselves with treatment: Diabetes (Type I or II), asthma, chronic kidney disease, depression, high blood pressure, and heart disease such as congestive heart failure.
On the other hand,
You may be able to get a plan designed for chronic conditions. These plans are more expensive and sometimes have higher deductibles, but they do not exclude people with pre-existing medical problems.
You can find these types of policies in the individual market and some group health insurance plans (typically only at larger employers).
Where to Find Health Insurance?
If you are looking for health insurance in the UK, go to a comparison site and enter your details.
You will be able to compare quotes from policies with different levels of cover and benefits before applying online or over the phone.
What Pre-Existing Conditions Are Not Covered?
A pre-existing condition is any medical problem you had before the policy started. Depending on your plan, insurance companies typically exclude conditions diagnosed or treated in the 12 months before coverage starts and serious illnesses such as cancer, stroke, heart disease, Alzheimer’s dementia, and Parkinson’s Disease.
Can I Be Denied Health Insurance Because of a Pre-Existing Condition?
No. Health Insurance companies can’t deny you coverage because of a pre-existing condition. Still, if the plan doesn’t cover certain conditions, this could mean higher premiums or out-of-pocket costs for any medical services related to these excluded conditions.
How Do Insurance Companies Know if You Have a Pre-Existing Condition?
Insurance companies usually ask for your medical history when you apply for coverage. You may be asked to answer a few simple questions about the conditions that have affected you in the past and whether they were diagnosed or treated within 12 months before applying.
What Are Considered Pre-Existing Conditions?
Some pre-existing conditions are associated with more severe health problems such as heart disease and diabetes. Others, like acne or high blood pressure, can be easily controlled with medication.
That was only the beginning,
With the changes in healthcare law, it is essential to know whether or not your pre-existing conditions will disqualify you from getting health insurance coverage.
Suppose you have had any of these health-related issues. In that case, you must be aware of the options available and contact your state’s Department for insurance information on how they can help if you qualify for coverage with pre-existing conditions.