Pre-Existing Condition & Its Role In Health Insurance

When applying for health insurance most people must go through underwriting. This process is done by insurance companies to figure out your health status when applying for coverage. It also helps determine if you are eligible for coverage, what price to offer it to you and what exclusions or limits might be placed on your account. Odds are your chances of higher insurance cost or being denied coverage (in specific situations) will come from pre-existing conditions. Today we will go through the most common conditions and its effects on your insurance.

What is Considered a Pre-Existing Condition?

A pre-existing condition is typically one for which you have received treatment or diagnosis before you enrolled in a new health plan.  These health problems can vary such as asthma, diabetes, epilepsy, or even cancer. The conditions also are usually long-term or chronic, while less severe conditions such as asthma, anxiety and sleep apnea may or may not. One pre-existing condition some forget to mention is pregnancy, is a pre-existing condition is you apply for insurance while pregnant.

Can I Be Denied Coverage?

As mentioned above in a specific case you can be denied health insurance. That case is if you have end-stage renal disease better known as Kidney failure. This is the only case when you can be denied health insurance, but for those with it, you are not left without a paddle! There are special programs specifically to help serve individuals with ESRD. Besides this specific case, no health insurance program can deny you coverage giving you more opportunity to get the help you need.

Do Pre-Existing Conditions Raise Insurance Cost?

Those with pre-existing conditions might end up buying a health plan with a higher premium to offer more coverage. Health insurers are not allowed to penalized for pre-existing conditions but might need more coverage. This means it’s not necessary to get a better plan, but probably the wise thing to do. This will help make sure that any extra help you might need because of your condition is covered, although it can get pricey depending on your condition and needs.

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  If you have any questions, comment below and your question may be the topic of our next post!

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