Insurance for Those With Pre-existing Conditions

A pre-existing condition is a term insurance companies use to define those individuals who have medical conditions, either temporary or permanent, that were present before the individual applied for health insurance coverage with their company. Having a pre-existing condition -- such as pregnancy, diabetes or depression -- can prevent an individual from getting health insurance or make it much more costly if she does receive coverage.

Waiting Period

• Many health insurance policies will accept someone with pre-existing conditions, but will make him wait between 12 and 18 months before the condition is covered. For example, if Bob has Type 1 diabetes and becomes self-employed, he can sign up for new health insurance. His new health insurance will cover any new medical conditions that arise during the first 12 months of his coverage, such as an emergency room visit for a broken arm. However, for the first 12 months, he will need to take care of any doctor visit for his diabetes and any prescriptions for his diabetic supplies or insulin.

HIPAA

• Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996. When a person or family needs to change coverage, this law helps limit exclusions of pre-existing conditions; prevents health care plans from discriminating against consumers by denying coverage or charging more; and guarantees that if a consumer loses her job and her coverage, she will have the right to purchase a new policy. These rules do not apply in all cases, and HIPAA does not require that an employer offer health care to the employees.

Government Coverage

• The United States government and most states offer a variety of programs for those without insurance who make under a certain amount of money each year. Older Americans may also qualify for Medicare. Programs run by government agencies do not generally deny coverage based on pre-existing conditions. Such coverage is usually solely income-based.

Other Coverage Options

• A person with a pre-existing condition can look to other places for help in getting health insurance. For example, if Jerry's new company doesn't offer insurance, he can look to his membership in the Association of Screenprinters for health insurance. Professional organizations often make deals with insurance companies to offer their members group health insurance. Organizations that deal with particularly diseases, like the American Diabetes Association, often have resources and help available for those suffering from a particular condition and can put individuals in touch with an insurance company or other official who can help them get the coverage they need.