Medical Insurance for Pre Existing Conditions

Will the new healthcare reform bill live up to its name? Some think so.

Today there are thousands of uninsured, underinsured and uninsurable individuals, who are facing serious health issues because of a pre existing condition. Obtaining affordable medical insurance for pre existing conditions is difficult for these individuals. It can be something as widespread as heart disease or something as life-changing as cancer. A family can be financially destroyed by a medical emergency unless they have quality health insurance.

The new Patient Protection and Affordable Care Act passed and changes are already starting to happen. One main element is the elimination of the pre existing condition requirement that is imposed by those seeking medical insurance.

Our children will be able to receive this benefit first. Starting in the fall of 2010, insurance companies will be barred from denying coverage to children who have a pre existing condition. This applies to new policies and for families who already have a health insurance policy.

Well... what about the adults. When can we expect to get this new insurance coverage?

It will be 2014 before this same exclusion protection granted to children will be available for adults. However, there is another choice that can be used prior to 2014. Over the coming 3 1/2 years, adults with a medical pre-existing condition will be directed to a new federal backup plan entitled 'Plan B".

This is a short description of how Plan B should work.

Some states have a regulated high-risk insurance pool. In fact, enrollment may still be open. First, check to see if your state has such a pool. It's interesting to note, these existing high-risk pools are not the same insurance pools established for "Plan B". States are being asked if they want to start or continue providing a risk pool. Your state may not have or maybe does not plan on starting a high-risk pool for those with pre existing conditions... but that's really not a problem. The Department of Health and Human Services will provide a pool for your state.

Starting in mid-year 2010 the temporary backup plan will be established for uninsured individuals with existing conditions. What will be created is a short-term, national high-risk insurance pool for the uninsured. Any US citizens or legal immigrants with health problems and who has been uninsured for at least six months will be eligible to enroll into this high-risk pool.

Compared to current state run high-risk pools, this new federal health insurance pool will be more affordable. But a word of caution... some individuals may still have a 25% higher premium than a comparable health plan for a healthy individual. The maximum out-of-pocket yearly cost sharing for enrollees should be no more than $5,950 for individuals or $11,900 for a family. It's been stated that some form of premium subsidy assistance will be available.

Until the end of 2013 this high-risk pool will continue to provide services. Then beginning in 2014, insurers will not be allowed to deny any applicants because of their preexisting conditions.

So it does look like the new healthcare reform bill will bring some major changes in the way insurance companies provide health care services for those with a pre existing condition.

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