Getting Coverage for Pre-existing Health Conditions

Insurance experts all agree: get health coverage before you need it. Applying for insurance after you’ve gotten sick or been injured can seriously hurt your chances of being approved for coverage.

But what if you’re one of the millions of people who have a health condition? Are you out of luck when it comes to finding insurance? Not necessarily — you just have to be extra-careful when you’re shopping for coverage.


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What You Need to Know When You Apply for Health Insurance

Before you actually buy an insurance plan, you apply for coverage. Your application is reviewed by a medical underwriter. The underwriter determines how much health risk you have, approves your application, and sets the price of your coverage. If the underwriter decides you have “high risk” health conditions, your application could be turned down.

But here’s some good news: medicine is improving every day, and the insurance companies know it. Conditions that were considered “high risk” twenty years ago are successfully treated and managed today. So even if you’ve had a condition that some companies won’t cover, it’s likely there are others that will accept you.

Before you start applying, you should talk with a licensed agent. Here’s why:

If you apply for coverage and are turned down, other companies may be more inclined to not accept you. (And yes, health insurance companies keep track of these things.)

Insurance agents work with these companies all the time. They have a sense of what kinds of conditions each company considers “high risk.” They may even be on a first-name basis with the underwriters at those companies. An agent can point you toward the insurance company most likely to accept you. In some situations, your agent can even put in a good word and help get your application accepted.

There’s one more thing to know about: the Health Insurance Portability and Accountability Act (HIPAA). This federal law requires insurance companies to provide coverage for your pre-existing conditions if you meet certain criteria. Learn more about HIPAA.

And If You Can’t Get Covered?

What if you apply and get turned down? You’re still not out of options.

First, look into joining your state’s “high risk pool.” These are insurance programs set up by state governments to cover people who don’t qualify for private coverage. The downside? They can be very expensive to join. And not every state has a risk pool. You can see a list of high risk pools here.

You should also consider joining a medical discount program. These programs don’t cost much to join, and most will accept anyone who applies. With one of these programs, you can enjoy a discount on doctor and hospital bills. Some programs also offer discounts on prescription drugs. Remember: these programs aren’t insurance. They won’t limit your out-of-pocket expenses. But they can help you save money on medical care.

Explore Plans and Talk With Agents

Want to see which companies have plans you may qualify for? Get an instant quote to see plans and prices online.

If you think your health may prevent you getting approved for coverage, talk with an agent. With one simple form, we can connect you with multiple agents licensed in your state. Take the time to talk with the professionals and explore your health insurance options.