Can I Still Get Health Insurance If I Have a Pre-Existing Condition?
If you have a health condition such as diabetes, sleep apnea, COPD, or cancer before you get health insurance, you may have a pre-existing condition. This is a health condition that occurs before or during your health coverage request. They are also conditions that are long-term or chronic. They are label ‘pre-existing’ conditions because the health insurance company expects them to return or be ongoing.
For a condition to be considered pre-existing, there must be an official diagnosis from a doctor or medical specialist. The diagnosis must include the time of the condition and previous treatment provided. Or the doctor must cite that the condition existed before the request for health insurance even if the condition was not identified in the past.
Common Pre-Existing Conditions
There is a wide range of medical conditions that can be considered pre-existing. The criteria for health insurance coverage are not the condition itself but rather when the condition occurred and if it occurred before the health insurance request. Some of the most common pre-existing conditions include
Several other common health conditions also would have qualified as a pre-existing condition. Pregnancy is classified as a pre-existing condition. Eating disorders are also pre-existing conditions, as is arthritis and even having had a knee replacement. HPV, which in some strains can be cancer-causing if left untreated, could also be classified by insurance companies as a pre-existing condition.
If you have had a back injury following an accident, that might be classified as a pre-existing condition. Alcohol or drug abuse, Crohn’s disease, and celiac disease all also have a history of being classified as pre-existing conditions. Along with Alzheimer’s, cerebral palsy, epilepsy, kidney disease, lupus, obsessive-compulsive disorder, multiple sclerosis, organ transplant, Parkinson’s disease, and strokes.
Am I Eligible for Health Insurance with a Pre-Existing Condition?
Whether you are eligible for health insurance depends on several factors, including
Your Health Insurance Plan
Under the Affordable Care Act (ACA), No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. However, insurance companies that are not part of the ACA marketplace can still deny coverage or charge you more for health coverage due to a pre-existing condition.
Some pre-existing conditions may be overlooked by the health insurance company depending on the severity of the condition, your last episode with the condition, and whether the condition is expected to return. It also depends on whether the condition is related to another medical condition for which you are receiving treatment.
How Much You Are Willing to Pay
Some insurance companies may provide coverage for a pre-existing condition. However, they will charge you more for coverage or alter your health plan based on the pre-existing condition. You can expect to pay hundreds of dollars more for health coverage in some cases. Also, not all plans provide comprehensive coverage, even if you are willing to pay more.
Riders/Waivers in the Health Plan
Last, some health insurance companies may issue you a health policy with a waiver or rider that exempts coverage for your pre-existing condition. For instance, if you have Crohn’s disease, you may not receive coverage for that condition or anything related to that condition. This makes it difficult to have a condition that affects several areas of your body.
Can My Health Insurance Broker Help Me Find Health Insurance?
Many people believe that their health insurance broker can work miracles and find health insurance coverage. While this may be true in some cases, it can be more difficult in others. Whether you can get coverage or not depends on the history of your condition and overall health. It also depends on how much you are willing to pay for health insurance.
Your health insurance broker’s job is to reach into their extensive network to find the best plan for you. However, if you are not getting insurance in the ACA, finding coverage can become difficult. The good news is that your broker will work tirelessly to find the right plan. Contact your insurance agent today to discuss your situation and explore your health insurance options.
Welcome to the MultiPlan PHCS Network
What are the benefits of PHCS coverage? You get to choose any doctor within the PPO network. This gives you an additional opportunity to save your healthcare dollars. MultiPlan’s PHCS Limited Benefit Network gives you discounted access to qualified doctors, healthcare facilities, labs, imaging centers, and hospitals at no additional charge.
Multiplan is one of the oldest and largest healthcare networks in the U.S. Currently, MultiPlan contracts with over 770,000 respected practitioners, 5,000 hospitals, and 70,000 ancillary care facilities, making it easier than ever for you to find a participating healthcare provider in your area. You save an average of 20-30% off inpatient and outpatient hospital charges when you use the MultiPlan Network.
Which Health Insurance Plan is Best for Me?
You may be wondering which health insurance company is the best? When choosing a plan, you first need to assess your personal healthcare needs, look at all your options, and choose a health insurance plan that fits your budget. How do you determine which health insurance is best? Ask yourself these questions:
- How often do you visit your doctor?
- What type of treatment do you need in the next 12 months?
- What prescription drugs do you currently take?
- Which healthcare providers/physicians do you prefer?
Once you decide your healthcare needs, you can narrow your search to health insurance companies in your state. Some of the health insurance providers that we work with include:
Contact Insurance Enterprise for Premier Health Insurance
If you have questions about group or individual health insurance and need health insurance quotes, contact Insurance Enterprise at 888-350-6605. Speak to a licensed agent and find out more about how you can get an affordable health insurance plan.