Insurance With Preexisting Conditions

Americans living with pre-existing conditions may find it difficult to find health insurance that both meets their healthcare needs and is affordable. In fact, some individuals cannot find private health coverage at all, instead opting to go without health insurance or turn to the federal government for assistance. Terms in federal health reform initiated in 2010, as well as rules in the Health Insurance Portability and Accountability Act are making it easier for those with pre-existing conditions to find coverage and will even the playing field for all Americans who wish to purchase insurance, regardless of health.

Employer Plans

• Many people suffering from pre-existing conditions find that enrolling in an employer's health plan is the easiest way to find affordable health coverage. The federal government and the U.S. Department of Labor regulate employer health insurance under the Health Insurance Portability and Accountability Act, or HIPAA. The law requires that health insurers extend health insurance to you once you qualify according to your employer's policies. At that time, the health insurance company can only refuse benefits for your pre-existing condition for up to one year if you enrolled during the health insurance open-enrollment period. If you enrolled late, you may have to wait up to 18 months before acquiring full coverage. Additionally, your premium will be much lower through an employer's plan, as the law requires employers to pay at least one half of each enrolled employee's health premium.

Job Transition

• If you experience a job transition, perhaps due to a lay-off, you may qualify for COBRA, which is an extension of employer health benefits until you find another job. Though you are responsible for paying your own premiums, the federal government will foot the bill for up to 15 months, after which time you must pay 100 percent of your health premiums until COBRA expires or you find coverage through another employer or private health plan. If you choose to continue your employer's health coverage, you will not lose coverage of your pre-existing conditions, and provided you do not go without coverage for more than 63 days in your transition period, your new insurance company at your new job must provide you with full coverage for your pre-existing condition without a waiting period.

Private Health Insurance

• If you do not have access to an employer's health insurance plan or you are self-employed, you may have to purchase your own private health insurance. Because HIPAA doesn't regulate private health plans, your insurance company may exclude coverage of your pre-existing condition in your policy or deny you an insurance plan altogether. If this occurs and you go without health insurance for at least six months, you may qualify for the federal pre-existing condition insurance pool, or PCIP. The PCIP works with private health insurance providers to extend affordable insurance with comprehensive benefits to those who cannot acquire health insurance elsewhere due to a pre-existing condition.

Considerations

• Thanks to The Affordable Care Act of 2010, Americans will not have to wait long before the discriminatory practices of health insurance companies become illegal. Under the law, beginning in January 2014, health insurance companies must accept all applicants who want to purchase health insurance regardless of any existing health conditions. Children, however, benefit from this law much sooner than adults. As of September 2010, health insurance companies cannot deny children insurance due to health issues.