How To Get Insurance with Current Medical Condition
For years it was almost impossible to find insurance that adequately covered preexisting conditions. This is no longer the case in the United States following the Health Insurance Portability and Accountability Act (HIPAA) which passed in 1997. Getting insurance with a current medical condition maybe easier than you think – in the United States at least.
Current Medical Conditions
According to HIPAA, a preexisting, or current, medical condition is anything that has been treated in the last six months. This does not include pregnancy or new babies. Those are not considered preexisting conditions at all and can not be subjected to wait periods. The only limitation an insurance agency can put on you (and your preexisting condition) is a twelve month waiting period before coverage for that treatment begins.
The Waiting Game
HIPPA also allows for your prior health insurance to be credited toward the twelve month waiting period provided you didn’t lapse in insurance for more than 62 days. This means that if you were diagnosed with an illness one year ago, but remained insured for that year, you no longer qualify for a waiting period and can begin new coverage immediately. An insurance company can not make you wait for treatment or deny you coverage based on that condition. This is true when going from one group plan to another, but things do become more complicated when a large insurance plan is not involved.
COBRA
If you are leaving a job for any reason but being fired, you can use your COBRA rights to continue your current benefits until you find a new job, preferably one with group coverage. COBRA will offer you the same insurance you had at your prior position, even if you are laid off, so your treatments should be covered for up to three years. During that time, you can find a new position or with the conclusion of treatments, lose your preexisting condition status.
No Coverage
If you are entering a group policy without insurance for the prior 62 days, you may be put on a twelve month waiting period – at least for the specific condition. This may also be true if you are seeking independent insurance not bound by group policies or limitations. If this is your case, consider taking the following steps to find coverage:
- Get a clause in an insurance plan excluding the specific medical condition, but allowing for coverage of any other sort.
- See what plans your state offers for those who can not get medical insurance.
- Look into plans and treatment options at county or state run facilities.
- Find a group of other independents to join that have a medical plan. (i.e. Realtors, artists, etc…)
- Get a catastrophic plan which doesn’t cover doctor’s visits, but does cover emergency care and hospital bills.
- Speak with a Health Benefits Counselor about your best options.
- Appeal the refusal – especially if there are additional state laws protecting citizens with poor health, obesity, etc…
- Wait it out. Find a way to make ends meet until the waiting period is up, and then never let your insurance lapse more than 62 days.
For additional information on insurance outside the United States, visit:
http://www.global-health-insurance.com/pre_existing_conditions.php
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