How Do Pre-Existing Conditions Affect Your Health Insurance Coverage?

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Health insurance can really be a lifesaver when it comes to covering you and your family during an emergency or even for preventive care.  With medical costs always going up, it is important to receive health insurance coverage from your employer or to find an affordable health insurance plan that you can pay for out of your own pocket.  However, one of the major drawbacks of health insurance coverage is that the companies that you purchase the insurance from often do not cover pre-existing conditions.  While shopping for the best package for you and your family, be sure to check the policy of every health insurance provider to determine their coverage of pre-existing conditions.

Defining Pre-Existing Conditions

If you already have an ongoing health issue or long-term condition prior to applying for and accepting health insurance coverage, that condition is deemed pre-existing.  Many health insurance companies will not cover the care you need to receive for these conditions.  Whether you are dealing with something chronic and serious, such as heart disease, cancer, diabetes, or asthma, if you have a minor ongoing condition, or if you were in an accident prior to receiving new health coverage and you are still receiving treatments for your injury, you can be denied coverage by your provider.

What If You Have a Pre-Existing Condition?

If you or your family members have a pre-existing condition, it does not mean that you will never receive coverage for the treatment you receive.  However, your health insurance provider may force you to pay a higher premium or you may have to deal with higher out-of-pocket costs.  Other providers may force you to get through a waiting period before coverage for your condition begins.  This is especially difficult for those who have conditions that require regular doctor visits and prescription medications.

Children with Pre-Existing Conditions

For children under the age of 19, pre-existing conditions must be covered by health insurance providers.  Therefore, if you are shopping for a new health insurance plan and have a child with a pre-existing condition, rest assured that the care your child receives must be covered.  New laws are also in place that will take effect in 2014.  They state that the same laws that affect children with pre-existing conditions will apply for adults or anyone over the age of 19, as well.  Therefore, the day is near when everyone will be eligible for coverage of pre-existing conditions.

Other Protections

Other protections are in place, which protect you from being denied health insurance for a pre-existing condition or having to get through a long waiting period.  For example, if you lose the job through which you were receiving health insurance, and you purchase a new health insurance plan before 63 days pass, your new healthcare provider cannot exclude you due to a pre-existing condition and you do not need to wait to receive your benefits.  This protection applies to both yourself as well as any member of your family who has a pre-existing condition and would be covered under a family health insurance plan.

About the Author

Laura writes for, a website that can help you to compare a variety of different health insurance plans within minutes.

Laura Ginn

Laura Ginn is a full time writer and editor and writes for a number of health and sports websites. Aside from writing Laura loves to read and is interested in such a vast range of subjects that it would be impossible to list them all here.

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