The Best Health Insurance for Pre-Existing Conditions

The existence of a pre-existing health condition could restrict your health insurance coverage options, resulting in higher plan premiums, coverage exclusions, rescission of benefits and even insurance application denials. Fortunately, the Affordable Care Act of 2010 allows Americans suffering from less-than-ideal health histories to find affordable health coverage through government-sponsored health plans.

State

• At the time of publication, 26 U.S. states offer a state-run pre-existing condition insurance pool. Benefits, coverage, premiums and eligibility guidelines vary by state. For example, a North Carolina resident enrolled in the North Carolina Health Insurance Risk Pool can expect to pay between $69 and $548 per month for comprehensive health coverage. The state allows those enrolled in the program to choose between four health plans with annual deductibles ranging between $1,000 and $4.500.

Federal

• The federal pre-existing condition insurance pool provides coverage options for individuals without access to a state-funded PCIP. The U.S. Department of Health and Human Services regulates the federal PCIP, requiring that those enrolled in the program be a U.S. citizen or legal resident. To qualify for the federal PCIP, you must have a pre-existing condition and either have been denied insurance due to your condition or have been previously uninsured for at least six months prior to applying for coverage through the PCIP. If accepted, you will receive comprehensive health benefits, including primary, specialty and hospital care.

Children

• If you are applying for health insurance on behalf of a child with a pre-existing condition, you may not have to look far to find coverage. In 2010, President Obama and congress enacted The Affordable Care Act, a health reform law that prohibits health insurance companies from denying coverage to a child under age 19 due to a pre-existing condition. In other words, you need not look to state or federal PCIP programs to find coverage for your minor dependent, as all health insurance policies must cover children regardless of their health histories.

Future Changes

• Beginning in January 2014, The Affordable Care Act will require health insurance providers to extend coverage to all Americans, regardless of pre-existing health conditions. The enforcement of this law will eliminate the need for state and federal PCIP programs, as health insurance providers will be required to provide complete coverage to policy-holders at an affordable, non-discriminatory insurance premium.