Health Insurance Articles

Pre Existing Conditions And How They Influence The Coverage Offered By A Health Insurance Provider

2010-05-14

Lawmakers and insurance companies toss around the words "pre existing conditions" quite a bit, and health insurance companies have been demonized for their practice of charging more or denying coverage for customers who are already sick in some way when applying for coverage. While this practice may be unfair, it makes sense from a business standpoint, as customers with conditions like asthma, cancer, or just about anything else cost insurers more money. Insurance companies charge more because they have to, and, right or wrong, it's an established part of the health care business. However, there are ways to avoid coverage changes due to this type of condition, though it's first important to understand your health insurance policy.

Just about any chronic health problem can be considered pre existing conditions, or, really, any health problem that hasn't been treated before healthcare coverage begins. Almost every health insurance provider in the country either offers less coverage for these types of conditions (as a special exclusion in each policy prevents the health insurance company from being liable for these types of medical costs) or requires patients to pay more for their premiums if such a condition has been recognized. You can usually contest a health insurance company's decision to deny you coverage or raise your premiums due to your condition, but their contracts are written in a way that favors the insurance company, and success in such a dispute is unlikely.

There's not many ways to guard against a health company's decision on your pre-existing or ongoing condition. The best way is to avoid a lapse in coverage. If your insurance record is spotted with several coverage lapses, the insurer will often point to these when declaring your condition to be preexisting, so minimize gaps by staying insured. If you're between jobs, get a stripped down, basic form of health coverage, then add more coverage and options when you've got a new job. Keeping yourself insured is a vital part of keeping your coverage strong.

If you haven't bought health insurance yet, it's helpful to get a full physical when applying. This can help you if you need to argue in the future that you didn't have a disease before you'd started paying for coverage. However, a full physical is not fail proof, and won't detect (or guard you against) some conditions. Carefully read the part of your health insurance contract that talks about exclusions, and note any language regarding conditions that are pre-existing. Health insurance isn't just a responsible buy, it's an absolutely critical buy--protect yourself by understanding your policy and avoiding any complications by keeping your coverage going. Talking with your health insurance provider may also help answer any questions you may have.