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Health Insurance and Preexisting Conditions


Over the last several months we have become all too familiar with the term - preexisting condition. The term means a condition that relates to a medical issue which was present prior to obtaining a health insurance policy.

While each individual insurance company will compile their own list of preexisting conditions, these are some forms of preexisting conditions:
-pregnancy
-obesity
-arthritis
-diabetes
-depression
-fibromyalgia

Often a health insurance company will require that a perspective insured undergo a waiting period before having their preexisting conditions covered under the health insurance policy. Most companies that offer individual health insurance policies require a waiting period of 12-18 months. During the waiting period the health insurer will not pay medical bills associated with the preexisting condition.

Fortunately, there are protections allotted to those with preexisting conditions. Under HIPAA, the Health Insurance Portability and Accountability Act you are entitled to have your preexisting conditions paid for by the new company. Under HIPAA, those who have previously been insured under a group health insurance plan and are obtaining a new type of health insurance may be able to have their preexisting conditions covered as long as they meet certain criteria.

A critical oomponent of HIPAA is that it relates to individuals who have been previously insured under a group health plan and not an individual health insurance policy. If you fall into this category, it is best to take advantage of HIPAA when you switch from a group policy to another group policy. Doing so will prevent you from having to pay for costly insurance due to a preexisting condition.

Individuals who do not have group coverage as an option may want to consider their states high risk insurance pools. Most states have a high risk insurance pool which provides coverage, albeit expensive coverage, to individuals with preexisting conditions.
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Content copyright © 2014 by Denise M. Castille. All rights reserved.
This content was written by Denise M. Castille. If you wish to use this content in any manner, you need written permission. Contact Denise M. Castille for details.

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