Pre-existing Medical Conditions and Insurance

Pre-existing medical conditions can make health insurance hard to find and costly to manage. For many years, individuals with pre-existing conditions could be turned down for medical insurance on the basis of the condition alone. When President Obama signed his healthcare reform into law in 2010, this changed. In the future, many insurance companies will have to accept clients with pre-existing conditions. However, the conditions can still affect how you are covered and how much you will pay.

Coverage Conditions

Insurance companies can elect to provide you with health insurance but exclude costs associated with your pre-existing condition. This type of policy adjustment may be found in the "exclusions" portion of your policy. In this case, it is very important to establish and understand which costs may be excluded. For example, if you have a pacemaker, your health insurance may refuse to cover the cost of replacements and repairs to the pacemaker. The insurance company may also, however, refuse to cover the costs of a hospital stay if you have a heart attack in the future. It is important to differentiate between the costs that are directly associated with a pre-existing condition and those that are not in order to get the best coverage.

Coverage Costs

You may have an elevated premium if you sign up for health insurance with a pre-existing condition. For example, if you have diabetes, the health insurance company may consider you a risk for a variety of other complications including blindness, heart disease, paralysis or kidney disease. First, be sure these costs are not excluded in your policy. You will need coverage due to your elevated risk. Unfortunately, you will have to pay more for this coverage than a person without diabetes would have to pay. The chance that you will need your health insurance is much higher, and you will have to share a bigger piece of the pie in terms of cost as well.

Coverage Cancellation

You must declare pre-existing conditions prior to signing up for health insurance. If you fail to do so, you could risk losing your coverage in the future if the company discovers your application was not truthful. However, anytime your coverage is denied or cancelled, you have a right to seek answers and, at times, compensation from an insurance company. For example, in the event of cancellation, you may have a portion of your premium refunded. If an insurance company denies a claim based on the presence of a pre-existing condition, you can contest the denial and seek payment. 

Finding Affordable Coverage

Unfortunately, dealing with costly coverage is part of having a health complication. There are some plans, though, that aim to minimize your expense by offering you more choices. These include health savings accounts and consumer-driven health plans. Consider opting for these methods if you would like to save money by choosing when and how to spend your healthcare dollars. With a heath savings account, you can spend pre-tax dollars on all expenses. With a consumer-driven plan, your high deductible will keep your premium low, and you may save money if you do not end up needing healthcare.

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