Pre-Existing Conditions and Health Insurance Author:    Posted under: Health InsuranceHealth Insurance questions answered

It can be tough to find insurance coverage especially with pre-existing and chronic health conditions such as heart disease, cancer, emphysema and even pregnancy. Insurance companies take a variety of factors into consideration when evaluating your application for health insurance coverage. Your age, sex, lifestyle and health status are all aspects that your health insurance provider looks at when evaluating you and calculating your risk.

Because of this, many people find themselves paying higher premiums or worse, rejected by yet another health insurance company.

But just because you have a pre-existing condition doesn’t mean there is no hope that you’ll ever find an insurance company that will provide coverage for you.

Group coverage, ones that are typically granted by employers are likely to be more affordable. Additionally, there’s a chance you may not be required to undergo medical examinations if you choose to participate during open enrollment.

High risk pools provide another option for you and can be found by calling your state’s department of insurance. Some states have high risk pools that accept individuals who are ineligible for coverage under other health plans. An applicant must have maintained coverage for at least 18 months prior to availing of the coverage or go through a waiting period before the coverage becomes effective.

COBRA is available to you if you leaving a qualifying group plan. It is important to note that COBRA is inapplicable to you if you have had individual insurance coverage.

Basic health insurance is a limited coverage plan that admits applicants under the age of 70. It pays for pre-existing medical conditions 6 months after enrollment into the plan. It only covers minimal medical costs, and limited items. Contact your state page at for information on availability, rates and enrollment.

Public assistance plans is one more option, especially if you have very limited income. The coverage of the plans will vary from state to state, or community to community. To find out more information on public assistance plans in your area, look in the blue pages of your telephone book under “Welfare Office”.

Recently, the states and federal government set up a program for individuals with pre-existing conditions to get temporary coverage. The new Pre-existing Condition Insurance Plan provides health insurance for those who have had no insurance coverage for at least 6 months, a health condition that has kept them from getting health coverage, and are U.S. citizens or legal residents in the U.S. Premiums vary from state to state, but the plan covers a wide variety of health benefits including hospital care, primary and specialty care and prescription drugs. Income is not a basis for the premiums and medical conditions will not result in higher rates. More information could be found on the PCIP website (

The federal government is financing the program until 2014, when the program ends. A new and more competitive insurance exchange is scheduled to be in place then. And the good news is by 2014 insurers will no longer be able to discriminate based on an individual’s health status. So people like you will be able to get medical coverage, pre-existing conditions notwithstanding.


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