Startling news shows that one in five California residents (under the age of 65) have a “pre-existing” condition, which could render them ineligible for coverage, or offered premiums at inflated rates. Though health care reform promises all Americans coverage by 2014, this still leaves many without the coverage they need for years. What is considered a pre-existing condition? Pretty much anything you have been treated for, or are currently under treatment for prior to applying for coverage. While not all conditions will result in your denial for coverage, it can result in an increase in the monthly premiums from 20% – 100% higher. If you had a lapse in coverage, but are approved for coverage on a new plan, there may be a waiting period of 6 months before anything relating to your pre-existing condition will be covered by your insurance plan. The good news is as of September of this year, children under the age of 19 cannot be denied coverage due to their pre-existing conditions.
As your full service agency, we are happy to answer any of your questions relating to eligibility for a plan due to pre-existing conditions, what kind of rate increases you may be looking at due to your health history, as well as determining whether or not the six month waiting period applies to your situation.
Tags: health insurance, individual health, pre-existing, premiums, underwriting
I will be getting married and will be looking to get health insurance for my wife. Over 5 years ago she had a kidney transplant and takes anti-rejection medication along with medication for high blood pressure and high cholestrol which are typical for someone with a kidney transplant. Currently she lives outside the US and is covered by insurance through her employer but that insurance is only good in her home country. Will I be able to get her insurance here in California? Also, can her existing coverage outside the US be used to show creditable coverage to eliminate pre-existing condition waiting periods.
I also have various medical conditions and have health insurance, HSA PPO, via HIPPIA guarnteed coveage rules through Healthnet.
I want to thank you in advance for your help in this matter.
Best regards,
Bob
P.S. Tried to use your contact form but always gave an error???
Hi Bob,
Unfortunately, due to her pre-existing conditions, your wife would not be eligible for an individual plan at this time. The only options would be either the Major Risk Plans (http://www.mrmib.ca.gov/mrmib/mrmipbro.pdf) or through an employer sponsored plan. Guaranteed issue plans for all people regardless of health status will not come into play until 2014. If you have any further questions, please email us at service@insuresaver.com. Thank you!