Having a chronic disease or a pre existing condition can be difficult to find health insurance. You may be wondering how you can still afford health insurance after the medical bill from your visit to the doctor. First of all, let me say that it’s not impossible find health insurance for preexisting conditions. Not everyone who is looking for health insurance with preexisting conditions has a challenge buying this insurance. Some people may have a larger challenge than others, but anyone who is in desperate need of health insurance can always start searching for health care plans

Buying health insurance is hard enough. We know, it’s our business. The reason health insurance is so confusing, especially when you’ve got a pre-existing condition, is that there are many factors to consider. Our job is to translate these factors into language you understand and boil them down to just two numbers: the cheapest premium and the lowest deductible. If your goal is to save money on your monthly payment or out of pocket cost, then follow these steps.

Buying health insurance is a confusing process, especially if you have pre-existing conditions. The good news is that there are many options available to you, and it’s possible to get the coverage you need at an affordable price.

Here are some tips for buying health insurance with pre-existing conditions:

1. Find out if your state has any laws that protect people with pre-existing conditions from being denied coverage. If so, these laws will apply to you—even if you’re getting your policy through the federal marketplace or another online insurance broker.
2. Research your options carefully so that you understand what benefits will be covered under your plan and how much it will cost. You can use the marketplace website or another online broker to compare plans based on price and benefits so that you can find one that fits within your budget while offering sufficient coverage of treatments and prescriptions that you need regularly.

How to get health insurance when you have a pre-existing condition

How to get health insurance with pre-existing medical conditions

Getting health insurance with pre-existing medical conditions can be tricky. It’s common for insurers to exclude pre-existing medical conditions from their insurance policies. The truth is, if they did include these conditions in their policies, they would have to pay many claims which means they would pay more on health insurance to the insured.

What is a pre-existing medical condition?

Pre-existing medical conditions are usually illnesses you know about before purchasing a health insurance plan. Any disease you may have had medical treatments for could also be included. Examples of pre-existing medical conditions include diabetes, Hepatitis B, epilepsy, cancer, High blood pressure etc. It’s a good idea to check with the insurer before purchasing a health plan.

Why do insurers not pay for existing conditions?

The main reason for health insurance is to cover yourself if something happens to you in the future. A health insurance covers you for unexpected illnesses or injuries that could affect you and your financial status. Unfortunately, health insurance is not designed for pre-existing medical conditions. If you already have any medical conditions, it may be hard to find insurers that are willing to onboard you with the existing conditions.

Can I get insured?

Yes, you can. Having a pre-existing medical condition does not mean that you cannot get insured at all. It means that your insurance provider is unlikely to pay out for any treatments, medication, and advice you may receive for any pre-existing conditions.  A lot of insurers will count anything that you have had treatment for in the past 5 years, as a pre-existing condition. Therefore, it is important that you find out everything before getting a policy with any insurer. You do not want pay a heavy medical bill after thinking that the insurance will cover it.

Some insurers may insure you and cover you for some of your pre-existing conditions if they believe that it’s unlikely for those conditions to re-appear.

Summarily, if you have a pre-existing medical condition, inform your insurer before purchasing a health plan so they can either insure you for it or inform you on how to cover the payment for future treatment of such conditions.

Can I Be Denied Health Insurance Because of articles Pre-existing Condition?

Primary Health Insurance

When it comes to your primary health insurance, the answer is no. According to the US Department of Health and Human Services, “Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have articles ‘pre-existing condition’ — that is, articles health problem you had before the date that new health coverage starts.” This law applies to plan years starting on or after January 1, 2014 (the one exception is grandfathered plans purchased on or before March 23, 2010)1. For more information about this law, visit hhs.gov. To know your health insurance options, visit HealthCare.gov.

Medigap Insurance

What if you have articles pre-existing condition and want to purchase articles Medigap policy? According to Medicare.gov, “even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health.” However, if you want to purchase articles Medigap policy outside your open enrollment period, the insurance company can sometimes refuse to cover out-of-pocket costs you may have for treatment for your pre-existing conditions for up to six months; after that period, “the Medigap policy will cover your pre-existing condition”2. For more information about Medigap policies and pre-existing conditions, visit Medicare.gov.

Supplemental Health Insurance

Let’s say you have articles pre-existing condition and you want to know if you can purchase supplemental health insurance. According to verywellhealth.com, the Affordable Care Act does not regulate supplemental health insurance, which means that “an insurer can deny coverage based on your medical history, impose limits on pre-existing conditions, and cap benefits at fairly low levels”3. And while you can purchase articles supplemental plan whenever you’d like (unlike primary insurance which is purchased during an open enrollment period), “many plans do exclude pre-existing conditions,” according to healthmarkets.com4. If you have articles pre-existing condition and would like to know your supplemental health insurance options, contact an independent broker or articles licensed insurance agent.

Which pre-existing conditions are not covered by Medicare?

Medicare defines a pre-existing condition as any health problem that you had prior to the coverage start date for a new insurance plan. If you have Original Medicare coverage or a Medicare Advantage plan, you are generally covered for all Medicare benefits even if you have a pre-existing condition. However, if you want to buy a Medicare Supplement (Medigap) insurance plan, there may be some exceptions.

What is the Medicare rule for pre-existing conditions?

Medicare won’t reject your enrollment if you have health problems.

Note that this doesn’t mean Medicare covers all treatment of every health condition. And even when Medicare does cover medical services, they often come with out-of-pocket costs for you (like deductibles and copayments or coinsurance).

Pre-existing conditions and Medicare Supplement insurance plans

Medicare Supplement (Medigap) insurance plans are sold by private insurance companies and can help you pay for out-of-pocket costs for services covered under Medicare Part A and Part B. Different Medicare Supplement insurance plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.

While Original Medicare doesn’t restrict coverage based on pre-existing conditions, the rules are different for Medicare Supplement insurance plans. In some cases, insurance companies can review your medical history and charge you more, impose a waiting period for coverage, or deny your application altogether.

The good news is that if you buy a Medicare Supplement (Medigap) insurance plan during your Medigap Open Enrollment Period (OEP), you typically have a guaranteed-issue right to a plan. Your OEP is the 6-month period that starts the first month that you have Medicare Part B and are age 65 or over. The plan can’t turn you down or charge you more if you have a pre-existing condition.

There aren’t any specific pre-existing conditions not covered by Medicare Supplement insurance plans; the health insurance company selling the plan establishes its underwriting guidelines regarding pre-existing conditions.

If you apply for a Medicare Supplement insurance policy after your Medigap OEP ends:

• Keep in mind that even if a Medicare Supplement insurance plan accepts your application for membership, the insurer may make you wait up to six months before covering your pre-existing condition(s). This is known as the Medigap pre-existing condition waiting period.
• If you’ve missed the Medigap Open Enrollment Period, you may still have guaranteed-issue rights in some circumstances. For example, if you enrolled in a Medicare Advantage plan and you’ve had it less than a year (12 months), you may have a “trial right” to buy a Medicare Supplement insurance plan. You’d need to drop the Medicare Advantage plan, return to Original Medicare, and then buy the Medicare Supplement insurance plan.

Can Medicare Advantage plans deny you for pre-existing conditions?

In the past, Medicare Advantage plans (except Special Needs Plans) didn’t generally enroll people with end-stage renal disease (ESRD), or kidney failure. Now Medicare Advantage plans may cover beneficiaries with ESRD, even if you qualify for Medicare before age 65 because of this disease.

Medicare Advantage plans won’t reject your enrollment if you have a pre-existing condition.

Pre-existing conditions and Medicare Special Needs Plans

You may be able to get Medicare coverage that’s specific for your health condition, whether or not you already had this condition when you signed up for Medicare.

You may be able to enroll in a Medicare Special Needs Plan (SNP) if you have a qualifying pre-existing condition. SNPs are a type of Medicare Advantage plan with benefits tailored for people with specialized needs.

One category of Special Needs Plans, the Chronic Condition SNP, is for people with specific diseases. You might be eligible to enroll in a Chronic Condition SNP if you have one or more of the following:

• Chronic alcohol and other dependence
• Autoimmune disorders
• Cancer (excluding pre-cancer conditions)
• Cardiovascular disorders
• Heart failure (chronic)
• Diabetes mellitus
• End-stage liver disease
• ESRD requiring dialysis (any mode of dialysis)
• HIV/AIDS
• Chronic lung disorders
• Chronic and disabling mental health conditions
• Dementia
• Severe hematologic disorders
• Neurologic disorders
• Stroke

If you qualify for a Medicare Chronic Condition SNP, you can enroll at any time if a plan is available where you live. Otherwise, you can still get your Medicare coverage through Original Medicare or a Medicare Advantage plan.