Pre-existing conditions refers to any medical illness or injury you had prior to enrolling in a health insurance plan. Pre-existing conditions were once seen as an impediment to getting or changing healthcare coverage, but that all changed with the passage of the Affordable Care Act (ACA or Obamacare) in 2014.
Now, unless your plan falls under grandfathered or short term policies, ACA compliant plans must cover preexisting conditions.
1. Look for a Plan That Covers Your Pre-Existing Condition
Prior to the Affordable Care Act, health insurers routinely denied coverage or charged more for people with preexisting conditions such as heart disease, diabetes, asthma, cancer and pregnancy. Such illnesses would typically have existed prior to enrolling or changing plans with health providers. They are considered “preexisting” since their symptoms existed prior to initial or later transition into health plans.
Typically speaking, these conditions won’t be excluded for an indefinite period; however, depending on your health insurance policy and state regulations it could possibly be excluded for an extended amount of time. Therefore it is crucial that you find a plan which covers your specific condition or illness.
Understanding your legal protections and options when searching for coverage of pre-existing conditions is also crucial. Under the Affordable Care Act (ACA), no health insurer may refuse coverage to individuals or families due to medical conditions that constitute pre-existing conditions; nor can they charge them more than other applicants due to such ailments. This applies for policies purchased via health marketplaces as well as state programs offering children and adult health coverage.
However, there are exceptions, including plans created prior to the Affordable Care Act passing in 2010 that do not have to cover preexisting health issues. Furthermore, health insurers do not have to adhere to all the requirements imposed by ACA so make sure you research all your options thoroughly before making a decision.
Pre-existing conditions refer to any illness or injury diagnosed and treated prior to enrolling or changing health coverage policies or coverage options. This could include all physical and mental conditions as well as any injury that was asymptomatic prior to applying for health coverage policies.
2. Talk to Your Doctor About Your Pre-Existing Condition
Under the Affordable Care Act (ACA or Obamacare), health insurers cannot deny coverage to people with pre-existing conditions or charge higher rates; however, this doesn’t mandate full medically necessary treatment of all pre-existing conditions; generally speaking, pre-existing conditions refers to health problems which existed or required treatment prior to shopping for health plans.
Before trying to secure health coverage for a pre-existing condition, it’s wise to discuss its nature with a doctor in order to avoid confusion and ensure you receive appropriate advice on managing or even curing it altogether. Your physician can help clarify its impact on overall health while offering suggestions as to how you might best address it or even eliminate it entirely – something insurance companies look at favorably as this lowers their risk. This increases approval chances or reduces premiums significantly.
Before the Affordable Care Act was implemented, health insurers used a look-back period to assess whether to cover preexisting conditions of an applicant. This time frame typically ranged between one and ten years and checked medical records of any conditions or treatments received within this timeframe; some might be known such as asthma or diabetes while others could go undetected until diagnosed by physicians.
Pre-existing conditions are now covered by all individual and large group health plans that offer individual coverage; pregnancy is not considered a pre-existing condition and newborns and children placed for adoption within 30 days are exempt from pre-existing condition exclusions. Unfortunately, certain short-term plans don’t offer this coverage and could exclude or deny claims relating to these pre-existing conditions.
Medicare supplement policies that are sold outside the marketplace also don’t need to cover pre-existing conditions, although they still may impose waiting periods or require pre-authorization before certain treatments can take place. Experience rating can also be used as a pricing mechanism and exclude certain conditions if treatment was received prior to commencing Medicare coverage.
3. Find a Plan That Covers Your Pre-Existing Condition
As it stands now, most health insurance plans cover pre-existing conditions. This applies to plans offered on the marketplace, through employers or directly from insurers as well as Medicare coverage. Furthermore, under the Affordable Care Act (ACA), all plans are required to include coverage of pre-existing conditions; however there may still be some plans that don’t; it is essential that you make an informed decision when selecting your plan.
Pre-existing conditions refer to any health issue or illness that existed prior to you starting your new health coverage, such as asthma, pregnancy, cancer or any other disease. Prior to the Affordable Care Act’s implementation in 2014, such issues often made getting coverage more challenging if not impossible; now however, insurance companies cannot deny you coverage or charge you extra due to pre-existing conditions.
There are some exceptions to this rule, however. If your health insurance plan started prior to March 23, 2010, it may qualify as a grandfathered plan and thus exempt from ACA requirements – meaning the insurance provider can still cancel or increase premiums based on preexisting conditions and short-term health conditions. This also applies for short-term plans.
Women who are pregnant or breastfeeding face special rules that apply specifically to them. According to the Affordable Care Act (ACA), pregnancy, childbirth and breastfeeding do not qualify as pre-existing conditions; however if they had had an abortion prior to giving birth it may qualify as such a pre-existing condition.
Cancer or blood disorders can also qualify as pre-existing conditions and make getting insurance difficult, though not impossible. If this applies to you, speak with your physician about what options may be available and find one that fits both your needs and budget. To start exploring your options enter your zip code above for an immediate list of plans and prices in your area; or work with a licensed insurance agent who will help explain all of them further.
4. Shop Around
As the Affordable Care Act (ACA) mandates that all insurance companies provide coverage for pre-existing conditions, you don’t need to worry about being denied coverage or paying more due to pre-existing conditions. Prices do vary between insurers though so it’s wise to shop around for the best rate; compare private health insurance quotes against coverage, costs and subsidies offered on your state Marketplace as well as life policies with pre-existing conditions such as term life or guaranteed issue policies without medical exams – consult a licensed agent for further advice!
