Health Insurance Options For Pre-Existing Conditions

What is a pre-existing condition?

Everyone who's ever had health insurance has heard of pre-existing conditions. But what are they really? A pre-existing condition is any condition that has been diagnosed or treated before the beginning of an insurance policy. Pre-existing conditions range from the flu to cancer. They also include maternity, chronic conditions like heart disease, and the lingering effects of injuries.

Why won't my insurance company cover a pre-existing condition?

If that sounds like a broad category, it is. But what an insurance company is really looking for in a pre-existing condition is their risk of high cost claims. They might not think anything of a patient with the seasonal flu. When underwriting group policies like those offered by employers, insurance companies are weighing the cost of claims for the whole group, not just in one person. In America, new members of a group are given by law a limit to the time an insurance company can refuse to pay claims on a pre-existing condition. Coverage on a previous group plan waives some of this pre-existing condition time.

What if I am pregnant? Can I get health insurance?

For maternity benefits, insurance companies can add a waiting period from the time of enrollment in the plan until the time these benefits are available. Any pregnancy that occurs during the waiting period is not covered. This is more common on individual family policies. Individual family policies are evaluated for risk based on the family. If one member of the family has a serious pre-existing condition, this can make getting individual family coverage more difficult.

What else can I do if I have a pre-existing condition and need health insurance or travel insurance?

So what can someone with a pre-existing condition do? There are several possibilities depending on the exact condition.

One is to stay on a group policy. Another is to be accepted for a guaranteed renewable individual policy before any pre-existing conditions occur. Then as long as you pay the premium, you can keep the coverage no matter the condition you contract in the future. A good broker should know which policies are guaranteed and which are underwritten individually each year.

You can also agree to strict coverage limits for your pre-existing condition or a rider leaving your pre-existing condition off the policy but covering other conditions. This is not to say that there are not some conditions that are simply very difficult to get coverage for. This often happens when someone on a employer's group policy must leave their job because of a disabling condition. A good broker will work to get you the best policy possible, but options can get very expensive.

You can purchase international travel insurance from multiple insurance carriers even if you have a pre-existing condition.