One of the more challenging realities in our health care system is that it can be very difficult for individuals with a pre-existing health condition to be granted or sold health insurance from one of the many providers on the market. From a business perspective, this makes sense; health insurance providers make money from taking on lower-risk patients, so it doesn’t make sense to offer health insurance to someone who may require expensive drugs or treatments. Luckily there are ways around this and some legal protection afforded to patients who fall in this category. Let’s take a look at some ways for getting health insurance with pre-existing conditions.
It’s best to begin with doing research about the different health insurance providers that are available in your city and state. Those that live in large metropolitan areas may have access to a wider range of providers than those that live in a small town, so it’s best to look everyone up so you can filter through all of your options. Once you have a short list of health insurance companies prepared, start reading through the policies available on their websites, or give them a call to discuss your situation and find out how they can help.
A quick side note: It’s best to go in to your research with the expectation that patients with pre-existing health issues will likely have conditions attached to whichever health insurance policy they subscribe to. Try to not be too selective or “picky” – especially if your pre-existing medical condition is one that would be considered serious or costly to treat. When you find a health insurance provider that is willing to take you on as a customer at a price that you feel is right for you – take it.
The best option for getting health insurance when you have a pre-existing health condition is to go for a group health plan, either through your employer or through a professional organization that you are a member of. Many group plans will simply accept everyone that signs up to ensure that the group is kept happy; many group health plans have hundreds or thousands of members, so they can be a significant revenue generator for the health insurance provider. Check with your human resources department, or do some searching around through organizations that you are a member of to see if you qualify for a group health plan.
If you’ve lost your job – and your health insurance – you can still gain health insurance through what’s called the “insurer of last resort”. Every state has a designated health insurance provider that is required to offer insurance to every single person who asks for it within 63 days of losing their group health plan or health insurance through work. As the states only guarantee this option for that 63 day window, it’s best to apply right after you lose your group or work health insurance. Don’t delay things just to see the window of opportunity close.
For those that don’t fall within the 63 day window to get health insurance from the insurer of last resort – try checking with your state’s health department to see if your state has a high-risk pool. High-risk health insurance pools are specifically targeted to those patients who have a pre-existing health condition but no insurance to assist them with treatment costs. More than half of the states in the country offer high-risk pools to their citizens, so check with your state to see if there’s one available to assist.
Finally, if all else fails it might pay off to start asking around inside your social circle and to others who have similar health issues in your area. Try leveraging your friends on Facebook and Twitter, and do some searching for local support groups or interest groups based around your pre-existing medical condition. It’s very likely that those who are suffering from the same health issue have already found how to gain health insurance to help with drug and treatment costs, so if you can find these folks they will be an invaluable resource.
If you have a pre-existing health condition and no health insurance – don’t despair. With a little bit of work, you can find insurance that will assist you in getting back to 100%. Self Health Insurance can also assist – we’ve built a tool right here on this site to allow you to search local health providers to find the best prices available. Simply head up to the top of this page and enter your ZIP code to get started!