Finding an affordable health insurance plan can be a challenging task. If you are living with a pre-existing condition or chronic illness, it becomes even more difficult. If you are one of the millions of Americans looking to find affordable private health insurance to cover your pre-existing conditions, then there are a few things you should keep in mind.
What Is a Pre-Existing Condition?
A pre-existing condition is a medical condition that exists before the start date of your health insurance benefits. Pre-existing conditions have become a controversial topic in health insurance. Before the Affordable Care Act, many health insurance plans would not cover any medical expenses associated with these conditions.
Insurance companies may define a pre-existing condition differently. Some companies consider these conditions to be any that you have received medical advice about before enrolling in a new plan. Other companies consider any condition to be pre-existing if you report that you had symptoms before the insurance start date, even if you never received medical care.
Some examples of pre-existing medical conditions may include:
Health Insurance And Pre-Existing Conditions
Before getting started, it’s a good idea to have a background on the relationship between health insurance and pre-existing conditions.
Prior to 2014, when the Affordable Care Act went into effect, health insurance companies were loosely regulated. Meaning, they were able to do whatever they wanted to boost their profits, which was bad news for high-risk individuals.
In an extremely brief overview, health insurance works by having a ton of members all pay monthly premiums into what is known as a risk pool. The health insurance companies bank on the fact that the majority of members will not need any medical services, and will use the risk pool for the members who do need medical attention. In order to prevent the medical bills from stacking up, it’s in the best interest of the companies to eliminate high-risk individuals or charge them a higher monthly premium.
For companies that do decide to cover pre-existing conditions, this results in a higher cost for individuals that have them. That changed after 2014.
Does Health Insurance Have To Cover Pre-Existing Conditions?
If you are purchasing coverage through the health insurance marketplace, then your health insurance plan is not only required to cover your pre-existing condition but charge you the same amount of money as if you didn’t have any chronic illness or disease. If you are purchasing health insurance outside the marketplace, then insurers are not required to cover your pre-existing condition.
Because insurers outside of the marketplace are not required to cover pre-existing conditions, it is crucial that you do plenty of research before deciding on a plan. When comparing plans, you should specifically study their terms on pre-existing conditions and their rates to make sure you are not caught by surprise. Taking the time to compare plans and maintaining careful attention to detail before signing up for a plan can save you plenty of money and headaches in the future.
The majority of people get health insurance through their employer. Fortunately, the rules surrounding employer-sponsored coverage also changed after the Affordable Care Act. Prior to Obamacare, if you had a pre-existing or chronic condition and you were eligible for employer-sponsored coverage, you probably had to go through a pre-existing exclusion waiting period, and it was usually limited to 12 months, or 18 months if you enrolled late.
After Obamacare was passed, those rules were thrown out the window. Today, if you are part of your employer-sponsored health insurance plan and you have a pre-existing condition, you will be covered, and there is no longer an exclusion waiting period.
Choosing Private Insurance for Pre-Existing Conditions
If you are not covered by your workplace and do not wish to use the public healthcare marketplace, you will need to purchase individual insurance from a private marketplace. Contrary to what many may think, private health for your pre-existing condition is an affordable option. With the rising prices of health insurance premiums through the marketplace, more Americans are turning to the private marketplace for coverage.
Yes, private health insurance companies do have the ability to deny you coverage, and even charge you more for your pre-existing condition, but there is a chance that it will still be cheaper than your options through the marketplace. The private health insurance market is full of affordable options. Switching insurance with a pre-existing condition may be stressful, but by considering all your options and making the right choice, you can make the process much easier.
What To Consider When Choosing a Plan
Depending on your needs, finding affordable health insurance can be a stressful task. It is crucial that you review your needs and carefully compare plans so you can best compromise with what’s available on the market. Here are a few things to consider when choosing a plan:
- Is your current doctor included in your plan? It’s best to choose a plan that doesn’t have your doctor out of network, or else you may need to pick a different doctor or pay out of pocket for appointments.
- Do you want one plan or separate plans? Adding your spouse to your plan may seem like a good idea, but not everyone should. In fact, you may be able to find better deals by choosing separate plans instead.
- Does the plan offer what you need? Don’t pick a plan that doesn’t meet your needs. This is especially important with pre-existing conditions, no matter if you are dealing with a heart condition or pregnancy. Avoid useless add-ons that will only increase the cost of your health care coverage.
Benefits of Private Insurance Plans
Despite the marketplace still being the most popular option for finding health insurance plans, there are multiple benefits to receiving a private insurance plan. In a private health insurance marketplace you can:
- Get access to free re-enrollment services
- Speak with local agents who can help you find an HMO that meets your needs
- Access resources to help you find the right coverage
- Receive 24/7 health insurance quotes
Find A Private Healthcare Plan With Coverage Guru
Yes, finding a comprehensive, beneficial plan can be a challenge with a pre-existing condition. Fortunately, with Coverage Guru, you can get the right help to reduce your stress. By putting the time into searching for the best medical insurance for pre-existing conditions now, you can save yourself even more stress down the road.
Regardless of your needs, Coverage Guru can help you find affordable health insurance plans. Compare quotes in your area by entering your zip code and getting covered today!