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In today's high cost insurance market it's more important than ever to compare providers for affordable insurance.

 

Check List for Pre-Existing Condition Health Insurance

 

How to handle denials and preexisting conditions

Finding health insurance for preexisting conditions is often difficult. No Connecticut individual health insurance company offers high risk health insurance for those with conditions like heart disease, active breast cancer and diabetes. You may however have other options for health insurance.

Here are some questions we suggest you ask yourself:

  1. First Step - Will every company consider this a preexisting condition?

  2. Second Step - Do I qualify for group health insurance?

  3. Third Step - What government programs am I eligible for?

  4. Fourth Step - Will I qualify for a short-term policy even with my pre-existing condition?

First Step - Will every company consider this a preexisting condition?

If you've been denied health insurance or fear that you might be turned down if you apply, your first step should be to make sure that every company will reject your application. If you are in Connecticut, you can request instant Connecticut health insurance quotes from us or call us at 1-800-467-8726. We work with every company and each company has a different set of guidelines. If you are not in Connecticut, you can request health insurance quotes for other states and speak with a broker local to you.

Second Step - Do I qualify for group health insurance?

Even if you have a one-man or one-woman business, you may qualify for a group health insurance plan in certain states including Connecticut. Please request Connecticut Group Health Insurance Quotes for Connecticut or Group Health Insurance Quotes for other states.

Third Step - What government programs am I eligible for?

Children with Preexisting Conditions

If in Connecticut, investigate The Connecticut Husky health plan. Rates are lower for low income families. However, Connecticut families of all income levels can apply.

Adults and Families with Preexisting Conditions

Investigate plans offered by the Connecticut Health Reinsurance Association. They can offer health insurance for diabetics and health insurance for others with preexisting conditions. The phone number for the Health Reinsurance Association is 1-800-842-0004.

Fourth Step - Will I qualify for a short-term policy even with my pre-existing condition?

Getting a short-term policy, not surprisingly, is not a long-term solution. However, you be asked only a few medical questions on the application, so you may be approved for a short-term medical plan even if you would not be approved for a permanent plan. Some companies do not ask your weight when applying for short-term policies.

Short-term insurance has significant drawbacks.

Even if you are accepted, preexisting conditions you have will probably not be covered. The primary reason these plans are good for people with preexisting conitios is that they will probably be covered for new conditions that are not related to their medical history. Medical bills incurred from a car accident that happens during the policy term is an example of expenses that are usually covered by a short-term plan. Another drawback is that these plans can typically be purchased for a maximum of six months. Also short-term plans cannot be renewed, so you will need to reapply and pass the medical underwriting again if you want to extend your coverage.

Bear in mind that insurance regulations vary from state to state. The information below is applicable to most of the US. However, some may not be. Also insurance regulations change from time to time, so some of this information may not be applicable when you read this. 

In Connecticut, my home state, one cannot be denied coverage if they get insurance through a group insurance plan. This is true even if the group consists of only one person. Unfortunately group insurance can only be purchased by a business. Therefore many people don't qualify because they are unemployed, retired or because they work part-time. 

Pre-existing Conditions - steps for finding coverage

  1. Always keep your present health insurance in force until you get a "yes" answer from your new insurer. Apply well in advance of the date your current policy expires. You will probably have to pay the first month's premium early. If you coordinate the dates properly, you can avoid paying two companies for the same time period of coverage

  2. Be forthcoming with your agent. You don't have to apply to learn whether or not an insurance company is likely to accept you. Try to find out before you actually apply whether or not you are likely (can only give you the probability) to be accepted. You don't want to waste time applying with an insurance company that is just going to say "no". Reputable companies will refund all of your money if they deny you. However, there is no point is being hassled by the paperwork if you can get a "no" answer up front. Most insurance companies will ask if other companies have denied you coverage. If you avoid applying for coverage with a company that will say "no" you can avoid answering that question the "wrong" way. As a general rule, insurance companies are not allowed to turn you down just because another insurance company has turned you down. However, if you have been denied coverage before, the new company will probably dig deeper into your medical history than they would have otherwise

  3. Don't take "no" for an answer until you know what each of the companies that serve your area are likely to do. Different insurance companies underwrite differently. I work with all of the insurance companies that serve Connecticut for health insurance. For some medical conditions, I'll find that Aetna will say "no" and Anthem Blue Cross say "yes" for other conditions it will be the reverse. This is why I recommend checking with all of the companies. I've compiled a list of Insurance Departments for each state to make this easy for you. You call them or visit their websites and see what companies provide health insurance on a non-group basis in your state

  4. If you've applied and were denied insurance coverage, find out why they said "no." Insurance companies have "waiting periods" for certain conditions. For example some insurance companies may not take you if you had a kidney stone in the last six months. Find out why they said no and under what conditions would they say "yes." You may only need to wait another month or get another pap smear with no findings. In some cases you can appeal their decision. You have rights that will vary from state to state. Contact your state's insurance department for information.

  5. If all else fails, contact your insurance department and ask them about the plans offered in your state for those who have been denied insurance. Usually these plans are more expensive than the standard plans, but they can provide substantial coverage. Another option may be for you to look into short-term health insurance. The applications for these policies tend to ask only a few medical questions. Some do not ask your height and weight. The ones that I'm aware of will not cover pre existing conditions and cannot be renewed, so there are some drawbacks to this option.

Perhaps the best advice I can give is to stay healthy. De-stress by finding healthy ways to enjoy your life and your family; eat well; drink plenty of water; get enough sleep; find a sport or activity that you enjoy (maybe one that involves your spouse and children).

 

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