Print Friendly and PDFPrinter Friendly Version

Friday, November 19, 2010

Expert Q&A: I have a pre-existing condition

Many of you have sent in questions about how the new health care law will affect you and your family. We’ve compiled answers for select questions to our experts in a short series to help you navigate changes to the health care system. Here's the latest:   

Question: I currently have a pre-existing condition. When will insurance companies be prohibited from denying coverage and charging exorbitant premiums to people with pre-existing conditions?

Answer: An end to insurance company discrimination against adults with pre-existing conditions will be fully implemented in 2014. This means that insurers will have to accept everyone who wants to purchase a plan, regardless of their health status. Additionally, insurers will no longer be able to charge sky-high premiums due to pre-existing conditions, such as asthma or diabetes. And they can no longer sell policies that exclude coverage for certain benefits based on a person’s pre-existing condition.

Children with pre-existing conditions don’t have to wait until 2014 to find a plan that will take them and won’t exclude care needed to treat their conditions. Starting September 23, 2010, a provision began being phased in to require that insurers cover all children under age 19 who apply for a plan, regardless of their health status.

So where can adults with pre-existing conditions find coverage today?

Until protections for adults with pre-existing conditions are fully implemented, they can get help from a temporary coverage program called the Pre-Existing Condition Insurance Plan (PCIP). Anyone who can’t buy private insurance now because of a pre-existing condition and who has been without health insurance for at least 6 months will be eligible to buy this plan. And premiums for this plan can’t be higher than the premium would be for a healthy person. Visit here to learn more.

For adults with pre-existing conditions, who haven’t been uninsured for 6 months or more, most states run high-risk pool plans to serve them. To learn about these plans contact your state’s insurance department. You can find you state’s insurance department by clicking on your state on this map.