Insurance companies can no longer deny coverage

12 Comment(s) Posted by Kate Blocher

It is likely sometime in your life that you, or someone you know, have been denied insurance coverage due to a pre-existing condition. According to a report recently released by the U.S Department of Health and Human Services:

"12.6 million non-elderly adults - 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market - were in fact discriminated against because of a pre-existing condition in the previous three years."

To make matters worse, even if an individual is able to gain coverage, insurance companies are still able to water down your coverage due to your determined pre-existing condition. For example:

"[S]omeone with a pre-existing condition of hay fever could have any respiratory system disease - such as bronchitis or pneumonia - excluded from coverage."

For the millions of Americans who have had to suffer under this discriminatory system, the passage of health reform is a true blessing. Insurance companies will no longer be able to turn down Americans for coverage based on their pre-existing condition, health status, gender or age.

Within the first 6 months of enactment, insurance companies will no longer be able to discriminate against children with pre-existing conditions; and by 2014 they will be prohibited from refusing coverage to anyone based on their medical history or health status. Until then, the federal government will provide insurance for those with pre-existing conditions through a national high-risk pool, or they will provide federal dollars to already established state high-risk pools to allow them to take in more participants.

There are many aspects of our health care system that make you want to scream, but the fact that insurance companies have been able to deny people access to care, simply because they happened to get sick in their past is one that has outraged many Americans for years. Thankfully, the new health reform law will make this injustice a thing of the past.

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Comments

  1. Scott B.'s avatar

    Scott B.

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    To get rid of pre-existing is a God send for millions of Americans that have silently suffered while many have enjoyed healthcare coverage through an employer. We have a small business and we have been rejected by 5 insurance companies with NO other choices left. Our current premium annually is $17,600 and not sustainable. Ironic that we exercise daily and are healthy but from an insurance perspective we don't fit into the cream of the crop selection that insurance companies practice daily. After all, we are in our 50's and from an insurance perspective we are not worth the risk. Thank you for giving us chance for a future. For the 50% of Americans that have insurance with your employer and don't have to face this kind of ordeal, I am truly happy for you, however, if you were to lose your job for some unforeseen reason and someone in your family has a pre-existing that could be as simple as taking a pill for mild depression or a disease that you have sucessfully treated, from an insurance perspective, you would be denied for the rest of your life. From a working business owner that has suffered rejection from the hands of several insurace companies concerning pre-existing, 2014 can't come soon enough. Please don't let it get repealed when there is hope on the horizen.
  2. Samantha's avatar

    Samantha

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    I wish that this part of the bill was one of the first things to go into action. I am only 25 and will soon have to find my own insurance plan as I can no longer be under my parent's insurance after 26. I do have a job, but it is with a very small company that may not ever get a group plan. This means I have to find my own individual plan, but since I have pre-existing conditions that sound bad on paper, but you'd never know just by looking at me, I have been denied by two insurance companies in the past six months. I am so fed up with looking for insurance. It is absolutely ridiculous that insurance companies can refuse coverage.
  3. Mark's avatar

    Mark

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    They have to offer you insurance, but they apparently do not have to cover the specific pre-existing condition for 12 months. One of my children has ADD and the medicine is expensive and we can't afford it....for the next 12 months. Some health-care program!
  4. Erin's avatar

    Erin

    Permalink
    Hi Mark,

    According to our policy experts, this should not be the case. If you bought the plan after the rule took effect, you should not be in this situation. If you bought it before the rule took effect (what's known as a "grandfathered plan"), they could still exclude some pre-existing conditions. We would recommend that you contact your insurance department to ask if your insurance plan is violating the law. You can find your state's insurance department contact info by clicking on your state here: http://www.naic.org/state_web_map.htm
  5. Joe's avatar

    Joe

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    I was in the hospital for a back operation. My insurance costs were too high and I had to change to a cheaper short term policy due to my divorce. I had complications while in the hospital. My old contract ended 08/31 and my new policy took effect 09/01. I went in 08/28 and was discharged 09/08. I receved a hospital bill for $310, 000. my insurance carrier will not cover 08/31 and my new insurance will not cover the stay due to complications. What can be done since the problem was not something I had control over?
  6. Joe's avatar

    Joe

    Permalink
    I was in the hospital for a back operation. My insurance costs were too high and I had to change to a cheaper short term policy due to my divorce. I had complications while in the hospital. My old contract ended 08/31 and my new policy took effect 09/01. I went in 08/28 and was discharged 09/08. I receved a hospital bill for $310, 000. my insurance carrier will not cover 08/31 and my new insurance will not cover the stay due to complications. What can be done since the problem was not something I had control over?
  7. Erin's avatar

    Erin

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    Hi John, The best resource for you is going to be here: (http://www.familiesusa.org/resources/program-locator/),

    If you're in a state that does not have a consumer assistance program, you can look up a legal services organization to find out about your rights. Here's our Guides to Finding Health Coverage at http://www.familiesusa.org/resources/resources-for-consumers/finding-coverage-2009.html.
  8. Patrick's avatar

    Patrick

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    One of the things that doesn't seem to get addressed in al of this is that even if you can secure a policy with a pre-existing condition, the cost may be prohibitive. I am self employed and have to pay almost $11,000 for a policy on just myself.
  9. Erin's avatar

    Erin

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    Hi Patrick,

    That will change in 2014. Then, plans won't be able to charge more based on health. Right now, the Pre-existing condition insurance plan, which is for people with preexisting conditions who have been uninsured 6 months or more, also has to charge standard rates - the same rates that health plans generally charge healthy people. But unfortunately, in most states, other plans still can charge higher premiums to people with preexisiting conditions health until 2014.
  10. osama's avatar

    osama

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    after i destroyed the twin towers in new york i started to have pains in my back and the insurance company would not cover my medical expenses... it seems just because i am a terrorist the insurance companies wont help me pay the medical bills.... makes me want to go blowshit up!!!
  11. Dee W's avatar

    Dee W

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    I'm confused. My current health insurance was started 4/2/10. As a condition of them writing the policy, they specifically excluded any past, present or future coverage for my herniated disk. I had no choice but to accept this exclusion. Can they still deny me coverage for treatment of this pre-existing condition or does this new law mean I would have to go with another insurer who would cover the pre-existing condition? Thank you!
  12. Gloria W's avatar

    Gloria W

    Permalink
    I also am still confused about what actually has been implemented as of 4/29/2012. Both me and my husband are self-employeed an both my husband and I have been denied medical coverage, because of pre-existing conditions. If I re-apply, does insurance company have to cover my pre-existing conditions? or do they have to just offer me insurance excluding my pre-existing? I have been living in fear for past 6 months w/o having medical insurance. Should I re-apply?

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