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What if I have a pre-existing health condition?

 

When the Affordable Care Act (ACA) became law on March 23, 2010 many individuals with pre-existing medical conditions had a reason to rejoice.  Under the previous law COBRA, individuals with serious medical conditions struggled to find health insurance that would pay for the care they needed.  Unfortunately this left some people with serious illnesses, unable to afford the medicines and other medical treatments that they needed to cure or alleviate their illness.

 

Under the ACA the problem of being denied insurance coverage because of a pre-existing condition will no longer exist. The new law provides that no individual can be denied health insurance for any reason, including any existing medical condition.

 

Some of the most common questions that have been asked about how the ACA will affect people with pre-existing conditions are:

 

Question:

Will insurance companies be able to charge higher premiums if you have a pre-existing condition?

 

Answer: 

No. Beginning in 2014 insurance companies, will be able to charge higher premiums based on age but will no longer be able to charge higher premiums because of health status or gender. 

 

Question:

Will the definition of pre-existing condition change under the ACA?

 

Answer: 

No. The definition will not change; it will become meaningless, because as of January 1, 2014 no one can be denied health insurance.

 

Question:

 Have insurance companies begun to find loopholes to get around the new pre-existing condition provisions?

 

Answer:

They have tried. A provision of the ACA prohibits insurers from excluding children younger than 19 with pre-existing health conditions went into effect. As a result a number of insurance companies stopped selling health insurance policies for children to avoid the cost of these potentially expensive policies. In response California penalized insurers that refused to sell child only policies by forbidding them to sell any policies. The end result was that all insurers moved back into the child only market effective January 1, 2011.  

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