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Ask the Health Insurance Expert
I have diabetes and it's been difficult for me to find affordable health insurance. They tell me it's a pre-existing condition. What does that mean?
A pre-existing condition is a health condition that was treated before the effective date of a new insurance policy. Health insurance companies want to keep risk to a minimum, so they often deny coverage for pre-existing conditions or charge exorbitant rates for people with pre-existing conditions seeking individual health insurance policies.
Group health insurance plans cover pre-existing conditions as long as the patient had health insurance for 12 months, without a gap in coverage of 63 days or more, prior to enrolling in the plan.
To make finding affordable health insurance easier, lawmakers focused on the issue of pre-existing conditions when they crafted the health care reform bill. Under the new law, insurers can no longer deny coverage for children's pre-existing conditions, and starting in 2014, they will be prohibited from denying coverage for adults' pre-existing conditions.
Until then, you might be able to find coverage through your state. Many states have high-risk health insurance plans for people who can't otherwise qualify for or afford coverage. In addition, federal and state governments have set up Pre-Existing Condition Insurance Plans in every state to provide coverage to people in your situation.
Go to the U.S. Department of Health and Human Services' consumer website, Healthcare.gov for more information. The site provides a wealth of information about upcoming changes under health care reform and provides a handy, step-by-step tool to help you find coverage options. Just click on "Find Insurance Options" on the home page to get started.
For more, see What is a pre-existing condition?