Which Health Insurance Accepts Pre-existing Conditions?

In 2014, discrimination for those with pre-existing health conditions will end. Per the Affordable Care Act, health plans will no longer be able to deny or penalize those with pre-existing conditions. Until then, you can still obtain coverage through individual plans, though it may be difficult to find affordable and immediate coverage. Group health insurance is usually available and the government-funded Pre-Existing Condition Insurance Plan is available when other coverage is not.

Individual Health Insurance

• Individual health insurance, also called private health insurance, provides insurance options for individuals and their families. To apply for coverage, you must complete an application that will ask about your past and current health conditions. Based upon your responses and other factors, such as age, the insurer will quote you a monthly premium rate. If you have any pre-existing conditions, the company may deny you insurance and decide not to quote or offer you a high premium. Some insurers will offer coverage but exclude the pre-existing condition or subject you to a waiting period before they will be covered.

Group Health Insurance

• Group health insurance, offered through employers and other groups such as associations or union trusts, is an option for those with pre-existing conditions. Most group health insurance is not subject to individual underwriting review by the insurance company, unlike individual insurance. Therefore, if you have a pre-existing condition and the opportunity to participate in a group insurance plan, you can obtain coverage without extraordinary high premiums or waiting periods.

The Pre-Existing Condition Insurance Plan

• The Pre-Existing Condition Insurance Plan is one of the provisions of the Affordable Care Act, enacted in 2010. The PCIP provides that states must offer health insurance to those individuals who cannot obtain or afford individual insurance because of pre-existing conditions. Some PCIP plans are available through your state while others are federally administered. To qualify, other than have a pre-existing condition, you must be a legal citizen without insurance for more than six months.

Bottom Line

• Many national insurers, such as United Healthcare, Aetna and your regional Blue Cross plan, may offer individual plans to those with pre-existing conditions, but be prepared for higher premiums and waiting periods. Take the opportunity to participate in group health insurance if available, as insurers will likely not deny you coverage for your conditions. If you cannot find individual or group health insurance, obtain coverage through the federally mandated PCIP.