Pre-Existing Conditions for Health Insurance Laws

Pre-existing conditions may preclude you from obtaining private health insurance policies, or render such policies unaffordable. Some of the more common pre-existing medical conditions include pregnancy, arthritis, diabetes, depression, fibromyalgia, gastrointestinal disorders and obesity. Each insurance company will have its own rules for insuring people who suffer from these conditions, but here are a few tips to help you understand your options. It is important that you do not allow your pre-existing condition to get in the way of obtaining health insurance.

Definition

A pre-existing medical condition means something different to each insurance company. Additionally, state law may preclude any definitions by insurance companies licensed to operate in the state. Certain conditions such as heart disease or diabetes are pre-existing, by their very definition, across the spectrum of insurers.
Some insurers consider successfully treated or eliminated conditions as pre-existing---as in the case of breast cancer or prostate cancer. Rule of thumb says that if you need to ask if your condition is covered, it is a pre-existing condition.

Private Policies

Some companies will not insure people with serious pre-existing conditions. Others may be willing to take the risk, but will add a premium or make your coverage subject to a long waiting period (3 to 9 months). During that waiting period, you cannot bill the insurance company for any treatment for the pre-existing condition.
It is important to shop around to find companies that are willing to cover you. Health insurance companies are numerous and you will find a full range of attitudes toward providing risky coverage. Each company has its own list of conditions they will cover and those that they consider too risky to cover.

Professional Groups

You may be able to secure a policy through membership in a professional group or a travel organization. Unions and organizations that cater to writers, performers and other freelancers often get to operate as employers would when offering a group plan. You may still be subject to waiting periods, but they may be shorter than if you applied on your own, and you won't be denied coverage.

Group Insurance

Group health insurance plans---of the type offered from employers---usually provide coverage to members regardless of pre-existing conditions. Most states offer an "insurance pool," or state-sponsored group plan that accepts all applicants. However, private insurance policies are generally more comprehensive than the public plans provided by your state. State plans could limit coverage to catastrophic events.
Private group plans may include a pool of people who work in the same field, but who do not work for a mainstream employer. In some cases, you may be able to join a private group plan.

Protection

The Health Insurance Portability and Accountability Act (HIPAA) states that an individual already enrolled in group insurance will have no waiting period after enrolling with a new group provider. HIPAA does not address individual health insurance coverage; it only deals with group health insurance.

References

• "Pre-existing Medical Condition" Defined
• Preexisting Conditions and Health Insurance
• Health Insurance For Pre-Existing Conditions