How to Get Your Pre-Existing Condition Health Insurance Coverage Approved

Having pre-existing conditions such as diabetes and heart ailments usually put individuals at risk for losing their security since they are considered to be liabilities in the short and long term. You have to show the agencies that you can adequately pay for the premium, as well as stay healthy enough to give them their dues too. Here are some tips from the experts.

People Unable to Get Coverage

There are plenty of individuals who are unable to purchase private health insurance because they have a known health condition or problem that is very expensive to treat. Insurance companies have the right to refuse to cover such individuals since they are considered as liabilities and may cost the company more than the actual premium that the individuals pay for. The insurer has to pay for medical fees expected from the individual.

When individuals get sick while on a coverage from one insurance carrier, they may be forced to leave the carrier to search for a new one, because they change occupation or the original insurer cancels the policy. The original insurer has to cover the primary phase of the condition, but new insurers will not want to pay for subsequent treatments. Big companies usually pay for all or any conditions, pre-existing or not to attract people with current medical problems, which is why a lot of individuals are attracted to their policies.

HIPAA Description

HIPAA or the Health Insurance Portability and Accountability Act was passed on July 1, 1997. The act includes a lot of aspects in health care, and already had a profound effect on health care being available to a lot of individuals in America. Because of HIPAA, there are rules that limit the longest amount of time that a pre-existing exclusion can be applied to a group plan. There are ways wherein you can minimize or eliminate the exclusion completely. Using the HIPAA guidelines, the highest amount of time that you need to wait to get more coverage for the pre-existing condition cannot go beyond 12 months or 18 months for those who enrolled late.

The main goal of HIPAA is to make sure that individuals with pre-existing conditions still benefit from health insurance. There is credible coverage by HIPAA too which pertains to any health insurance you had in the past, given that it was not interrupted over a period of 63 or more days. The time period can extend, depending on the laws of the sate and the kind of insurance plan you had before.

More on HIPAA

If you have provided sufficient evidence that you had uninterrupted insurance before the current plan, the insurance coverage can be credited toward any pre-existing condition exclusion you have before. If you had a minimum of 1 year of group health insurance during a single occupation then got health insurance at a new work without getting a break longer than 63 days, exclusion on any pre-existing condition you may have cannot be imposed by the new health insurance plan.

Exclusions for hidden pre-existing condition include denial of medical coverage for the treatment of injury stemming from accident before the plan was acquired, counting the coverage of a previous health insurance toward another plan's lifetime coverage limit and failing to cover a congenital medical condition, if the condition can be covered if found not to be of congenital origin.