health insurance individuals pre existing conditions
health insurance individuals pre existing conditions
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What You Need to Know About Pre-existing Conditions
Buying insurance is hard enough as it is – it’s close to impossible to find coverage when you have a pre-existing condition. But what is it and what do you do when you have one?
It’s a medical condition that was already there before you tried to obtain your health insurance. This could be anything from back pain to ADD to cancer.
In most cases, if you have such a condition, insurance companies will make you wait for 9 months before providing coverage on that condition. So while other forms of insurance may be extended to you, back X-rays or ADD medication or chemotherapy won’t be covered for 9-12 months after you’ve signed with the company.
This sounds like a raw deal, and in many ways it is, but there are a few programs that exist that make it a little less disturbing. The HIPPA laws dictate that if you’ve been insured with another company for 18 months, and you switch insurance companies, the new company must give you credit for those 18 months. But of course, there is a catch: the switch has to take place in roughly 2 months. You can’t work for 18 months, be uninsured for 10 years, and then expect a new insurance company to credit those 18 months.
However, insurance companies are not eager to take on projects that have a lot pre-existing medical conditions, and many companies will declare you to be too high risk to insure. In that instance, there are other forms of insurance that can help. They may provide less protection than major medical insurance programs, but they are also significantly less expensive, and have more liberal coverage for pre-existing medical conditions. And you’ll be happy to know, at least one of the following types of coverage is guaranteed to almost all U.S. residents.
Core Health Insurance
Core Health Insurance is a limited benefit insurance available to U.S. residents in the majority of states. This policy has a maximum lifetime benefit of $1 million, meaning if you need a lot of hospital and surgical care, you may find yourself out of insurance by 50. If you are under 65, even if you have a pre-existing condition, Core Health Insurance will cover you. There is a 12-month period for surgical benefits if you have a pre-existing medical condition, however.
Value Benefit Plans
The big 5 Value Benefits include Value Health USA (hospitalization/ surgical cost), Value 24 Hour Accident, Value 24 Hour Accident Coverage, Value Emergency Room Insurance (emergency room and ambulance cost) and Value Med (doctor visits, lab fees). These plans can be bought individually, to mix and match an insurance plan which works for you. What you save in money, you save in comprehension: Value Benefits are not available for the most severe pre-existing conditions like AIDS, cancer, and diabetes. These policies are available in most states to individuals with pre-existing medical conditions after a waiting period of 12 months.
About the Author
Nicholas Wright has worked in the insurance industry for several years. Because he believes consumers should be well-informed, he blogs to help those seeking insurance information. Whether you’re just trying to find a cheap health insurance plan or you’d like to learn more about the terminology used in insurance policies visit: http://thehealthinsuranceblog.org/
How can I be covered for a pre-existing medical condition?
Upon graduating college, coverage for my health insurance under my fathers group insurance ended March 31,2009. To my dismay I dislocated my knee cap about a month and a half later on May 11,2009 (I didn‘t have health insurance when this happened!). I just purchased an individual health insurance that coverage started in the beginning of June 2009 (they will not cover any pre-existing conditions). But, when I dislocated my knee I didn’t have any health insurance. I’m not familiar with Florida health laws concerning this, but I read somewhere online that if there is a short time gap (2 months I read) that you didn’t have health insurance, that there is a way to be covered for a pre-existing condition.
My question is, what can I do to be covered for this injury(already costing me over $5,000)? For example: Cobra, takeover coverage etc…
Any advice would be much appreciated.
Not true. What you’re referring to, is when you move from ONE group coverage, to ANOTHER group coverage, the new group isn’t allowed to exclude coverage for preexisting conditions that were covered under the first policy, if the lapse in coverage is less than 63 days.
That’s not your situation, though, because 1. your new policy isn’t a group coverage and 2. there wasn’t coverage in effect at the time of your loss.
The wait, for coverage on preexistings, is 18 months. You COULD have tried to sign on to Cobra at the time of the injury, under your father’s group policy, because the injury was within 60 days . . . however, it’s NOW too late.
Even the Florida State High Risk Pool will make you wait 18 months AFTER you sign on.
You’re not going to be covered for this injury, unless you can get onto WELFARE health insurance. That’s the only program that covers preexisting injuries. sorry.
