Overview on USA Healthcare Insurance - Dealing with Pre-existing Diseases

Dealing with Pre-Existing Diseases

Before the enactment of the Health Insurance Portability and Accountability Act (HIPAA) in 1997, people had to undergo mental ordeal about health insurance coverage for pre-existing conditions such as diabetes, hypertension heart disease or cancer. Incase if an individual changed organizations or jobs for greener pastures and subsequently had to switch the insurance companies in the entire process, the concerned individual was unable to benefit some of the healthcare services on account of the pre-existing disease or condition exclusion clause. With the introduction of HIPAA, it helps in assuring continued insurance policy coverage for employees and their dependents, regardless of any pre-existing diseases or conditions. However, Insurers (or Insurance Companies) can impose a 12-month (or one year) waiting period for any pre-existing condition that has been diagnosed or treated within the preceding 6 months. As long as an individual possesses a continuous health insurance coverage without a break of not more than (or exceeding) 63 days, his/her previous health insurance coverage will be credited towards the pre-existing condition exclusion period.

Incase if an individual possesses Group health coverage for minimum 1 year period and change jobs and health plans, in that case the brand new insurance plan cannot impose another pre-existing condition exclusion period. If an individual have never been covered by an employer’s group plan and he/she joins a new job that offers such an insurance plan, then such an individual may be subjected to a 12-month pre-existing condition waiting period. In addition, federal laws of USA make it easy for an individual to purchase or acquire individual insurance under certain situations. In such cases, the individual may, however, have to pay a higher premium for individual insurance if he/she has a preexisting disease or condition. If an individual does not have insurance coverage previously and are unable to acquire insurance individually, he/she should check with the State insurance commissioner to see if his/her State has a high-risk pool. The individual can find the phone number for the State insurance commissioner in the blue pages of the local telephone directory.