Preexisting Conditions and Health Insurance: What You Need to Know

If you’re like many Americans, you may have a preexisting health condition. This means that you have a medical condition that was diagnosed before you applied for health insurance. In the past, preexisting conditions could make it difficult to get health insurance or could lead to higher premiums. However, thanks to the Affordable Care Act (ACA), this is no longer the case.

Navigating Health Insurance with Preexisting Conditions

The ACA prohibits health insurance companies from denying coverage based on preexisting conditions. This means that you can’t be turned down for coverage or charged more for coverage because of a preexisting condition.

Special Enrollment Periods
If you have a preexisting condition and you’re not currently enrolled in health insurance, you may be eligible for a special enrollment period. This means that you can enroll in health insurance outside of the open enrollment period. To qualify for a special enrollment period, you must have a qualifying life event, such as losing your job, getting married, or having a baby.

High-Risk Pools
Before the ACA was passed, people with preexisting conditions could only get health insurance through high-risk pools. High-risk pools were government-run programs that provided health insurance to people with preexisting conditions. However, high-risk pools were often expensive and had limited coverage.

Medicaid Expansion
The ACA also expanded Medicaid to cover more low-income Americans. Medicaid is a government health insurance program for people with low incomes. If you have a preexisting condition and you qualify for Medicaid, you can get comprehensive health insurance coverage at a low cost.

Other Options for People with Preexisting Conditions
If you don’t qualify for Medicaid or a special enrollment period, there are still some other options for getting health insurance with a preexisting condition.

– Employer-sponsored health insurance: If you work for a company with 50 or more employees, you may be eligible for employer-sponsored health insurance. Employer-sponsored health insurance is often more affordable than individual health insurance.
– Association health plans: Association health plans are health insurance plans that are offered by trade associations, professional organizations, and other groups. Association health plans are often less expensive than individual health insurance plans, and they may offer more coverage.
– Short-term health insurance: Short-term health insurance plans are temporary health insurance plans that can provide coverage for up to 364 days. Short-term health insurance plans are often less expensive than individual health insurance plans, but they may not offer as much coverage.

Getting Help with Health Insurance
If you have a preexisting condition and you need health insurance, there are resources available to help you. You can contact a licensed health insurance agent, or you can visit HealthCare.gov. HealthCare.gov is the federal government’s health insurance marketplace. On HealthCare.gov, you can compare health insurance plans and enroll in a plan that meets your needs.