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What is a Pre-existing Health Condition?

A pre-existing condition is a medical condition, disability or illness that you had before you enrolled in a health plan. For example, if you took medication for arthritis last year, then the arthritis is a preexisting condition when you enroll in a plan this year. To be considered a preexisting condition, it does not necessarily have to be a chronic, ongoing or long-term problem. A short-term condition like pregnancy may qualify as a preexisting condition.

Typically, when you apply for coverage, the insurer asks you to identify all medical problems that you’ve had diagnosed or treated, and it checks your records with your previous insurer. Currently, group plans offered by employers must cover all preexisting conditions. However, if you have an individual plan, the insurance company can deny coverage for preexisting conditions.

Examples of Pre-existing Health Conditions

  • Asthma
  • Diabetes
  • Cancer
  • Depression
  • Attention Deficit Disorder (ADD)
  • High Blood Pressure
  • Heart Disease
  • Allergies
  • Abnormal Pap Smear
  • Heart Attack

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Will my pre-existing condition be covered?

The Affordable Care Act, sometimes called Obamacare, has several provisions that give greater protection to patients with preexisting conditions. Starting on Jan. 1, 2014, insurers will not be permitted deny coverage based on pre-existing health conditions, which means:

In addition, insurance companies are not allowed to cancel coverage due to a mistake or a minor omission on a patient’s insurance application. In the past, they have used this practice, called rescission, to save money by weeding out the sickest and most costly patients. Under the Affordable Care Act, rescission is now illegal except in cases of fraud or intentional misrepresentation on an insurance application. That provision took effect on Sept. 23, 2010.


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2014 Affordable Health Care Coverage Facts

Open Enrollment Ends March 31

If you don’t have health insurance coverage in 2014, you’ll have to pay a tax penalty. This fee will increase every year. Depending on your income, you may qualify for financial assistance; our form help will determine whether or not financial assistance is available.

Essential Health Care Benefits

All Health Insurance for Pre-existing Conditions plans sold, on or off the health insurance exchange must offer the same essential benefits like maternity care, prescription drug coverage, and you cannot be denied coverage. Compare our health plan rates to the health insurance marketplace.

What is Obamacare?

Obamacare includes private health insurance and federally-sponsored health plans; it does not create health insurance plans. You can buy health insurance outside the Health Insurance for Pre-existing Conditions Exchange and in many cases, this will save you money.

Can I Use My Health Care Subsidy?

Our short form will let you know if you’re eligible for financial aid to help pay for your health care plan. If you are, we will match you to the right provider so you can get the most out of your subsidy.


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Health Insurance for Pre-existing Conditions Plans

Individual Health Insurance Plans

Individual health care plans are designed for single people and can usually be tailor made to your specific insurance needs. For the best rate, you should compare private individual health insurance plans to plans from the Health Insurance for Pre-existing Conditions Marketplace.

Family Health Insurance Plans

Family health care plans are great for the self-employed or when you work for a smaller company that does not provide health coverage, family health insurance offers affordable protection for you, your family. Compare our rates to the healthcare marketplace.

Group Health Insurance Plans

If you run a business and want to help your employees find health coverage, a group health insurance plan will allow you to provide health coverage for employees.

Emergency Health Insurance Plans

Emergency health care plans are typically well suited for young people who only require very basic health coverage and coverage in emergencies. They are usually less expensive than standard health insurance plans.


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Private Health Insurance for Pre-existing Conditions Options

HMO Health Insurance Plans

HMOs, or Health Maintenance Organizations, offer health care from a network of health care providers. HMOs tend to have respectable premiums and deductibles, but offer limited flexibility for choosing doctors and hospitals. Under an HMO plan, you need a referral from your primary care physician to see a specialist and you may have to pay 100% of cost if you see a doctor out-of-network.

PPO Health Care Plans

PPOs, or Preferred Provider Organizations, also have affordable premiums and deductibles – however, they offer more flexibility to see any doctor you want and don’t require a referral from your primary care physician to see a specialist (as is required from an HMO). Under a PPO, out-of-network costs are covered, but at a lower rate than in-network costs.

High Deductible Health Care Plans

High Deductible Health Plans, tend to have lower premiums than both HMOs and PPOs, but much higher deductibles. Deductibles are the out-of-pocket expenses you have to pay before insurance starts to cover you. You can use an HSA to lessen the financial burden of covering the high deductibles. These plans generally have similar flexibility to PPO plans.

Health Savings Account

HSAs, or Health Savings Accounts, are growing in popularity for a variety of reasons. Though they may not be for everyone, if you can afford to put up the money up front, you can benefit from tax savings, and people typically save a decent chunk of money when all is said and done because they don't have to pay the expensive premiums.


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Compare Health Insurance for Pre-existing Conditions

Shop, Compare & Enroll Online

You can shop, compare, apply, and enroll for health insurance online. You will be able to see rates and plans before you apply and you don't need to create an account to get started.

Get Personal Help by Phone

We have operators standing by to help you fill out the forms, answer questions. You can also get rates, compare plans and complete your enrollment by phone with a licensed agent.


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Lower Costs on Health Insurance for Pre-existing Conditions

Compare Marketplace Rates

You can quickly compare rates for inexpensive ACA-approved Health Insurance for Pre-existing Conditions plans & apply online. You can also compare government subsidized plans quickly and easily.

Use Your Subsidy

You will find out if, based on your income and household size, you are eligible for a subsidy (government financial assistance) and if that's your best option, apply the subsidy to your health premiums.


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