Insurance for Preexisting Conditions is More Affordable

Insurance companies can have strange working methods. They refuse to cover people who are in need of health coverage the most. These are people who already suffer health problems and have to incur considerable medical expenses. Well, the insurers have their reasons, but for people in need of insurance for preexisting conditions, this limitation in insurance can be extremely debilitating.

A good option is to choose policies specially designed for these people. Yes, premiums are slightly higher and terms and conditions are more complex, but satisfactory cover is available. Medicare, for one, does not discriminate people who suffer ailments. The policy covers everybody regardless of their health condition. Medigap, on the other hand, can refuse insurance for preexisting conditions, but eligibility is reviewed after six months. This period can be used by people for treating the illness. Until you become eligible for Medigap, you can use Creditable Coverage.

What does insurance for preexisting conditions offer?

Preexisting condition insurance plan or PCIP was introduced in July 2010 and covers primary and specialty care, hospital expenses and prescription drugs. Premiums are higher for PCIP when compared to normal policies and change from state to state. Income and the kind of existing illness are not eligibility factors.

What are the eligibility criteria?

PCIP conditions for qualification are pretty straightforward. Ironically, eligibility criteria are tougher.

Qualification criteria:

  • Should be US citizen or a legal resident of the country
  • Should have a pre-existing illness
  • Should not be covered under any other health policy for at least the last six months
Eligibility criteria:
  • Should not be enrolled in any other policy, irrespective of whether the policy covers your preexisting condition. This includes job based covers
  • Should not have any kind of limited insurance policy
  • Should not be a Medicare, TRICARE, CHIP or VA beneficiary
  • Should not be a part of high risk pool set up by the state
Documents required (at least one among these needs to be produced)
  • Letter of rejection from any other registered insurer
  • Offer letter for insurance coverage in the past year which you rejected because it did not provide adequate cover and/or because of very high premiums
  • A doctor’s letter, dated anytime in the past one year, proving your illness
These requirements can change from state to state.

Insurance for Preexisting Conditions: Government Initiative

PCIP was formulated under Affordable Care Act. The federal government offers funds under this Act to run PCIP programs. The Department of Health and Human Services is constantly pushing for lower premiums and better coverage for people who require health coverage the most.

What is the future going to bring?

2014 is going to be one of the major milestones in the health insurance industry. From 2014, all public and private insurance company will be prohibited by law from refusing insurance for people with illnesses. What is more, the new insurance regime forbids any increase in premiums or deductibles for people who suffer life threatening illnesses such as cancer, cardiac ailments, asthma or diabetes. Eligibility criteria are going to be relaxed. In several states of America, premiums have already dropped by as much as 40 percent, especially in states where PCIP is controlled by the federal government.

To conclude, times and insurance laws are set to change in favor of people with preexisting conditions.