It’s a sad fact that many Americans are without health insurance. For some it’s a matter of choice, others simply can’t afford it. There is a third group however, who can afford it and desperately want it, but are unable to qualify for it because of their current or past health conditions. These are what insurance companies refer to as the “uninsurables”.
The presidential candidates this year all put forward ideas for fixing the broken health care system in this country. Hopefully, there will be sweeping changes made that will allow everyone access to affordable healthcare. In the meantime, if you are sick and uninsured, you can’t wait for the politicians to fix the system. You need help today.
Here are a few ways you can get yourself insured now:
1. Get a job. If you’re healthy enough to work, getting a job with a company that offers health insurance benefits may be your ticket to healthcare. As a new employee, you are guaranteed to get coverage. You will have to wait 6 after enrolling in the company’s insurance plan before any pre-existing conditions are covered, but after that you will have full coverage. If it has been less than 63 days since your last insurance policy lapsed, you may have what is referred to as “creditable coverage” which means that the pre-existing clause will be waived and you can get full coverage right away.
2. Start your own business. In the state of California, you can get guaranteed-issue group coverage with as few as two employees. One of these employees can even be your spouse. Things to keep in mind:
a. It must be a legitimate business, but it doesn’t have to show income for the first two years;
b. The business must be the major source of income for all employees You can’t include an “employee” who earns the majority of his/her income from another source.
c. There will still be a waiting period for pre-existing conditions (unless you’ve had creditable coverage within the last 63 days) but once the waiting period is satisfied, you’re good to go. Talk to your local health insurance agent to see if you can qualify for a group health plan.
3. Get married. No, I’m not suggesting you grab some stranger off the street and arrange a marriage of convenience. However, if you already have a life partner, or are in a serious relationship that is heading toward marriage, you might want to consider taking it to the next level. There are many legal benefits to marriage. One of them is access to your spouse’s health insurance. If your spouse-to-be is already insured through their place of work, you can be added to their policy without any underwriting requirements (usually). Again, there may be a waiting period where pre-existing conditions are excluded, but once you’ve satisfied the waiting period, you’re 100% covered.
Have your spouse-to-be check with his/her human resources department to get the full scoop.
4. Consider a mini-med product Some states have what is referred to as “mini-med” products. They are NOT major medical plans and don’t pretend to be. However, they are guaranteed issue (you can’t be declined because of poor health) and they do pay a limited benefit. Something is better than nothing. Although California does not currently offer such a product, it will very soon. We’re told it is coming “any day now.”
Check with your local health insurance agent to find out more.
By: Tamarin Martin
Posts Tagged ‘Creditable Coverage’
Uninsurable? Four Ways to Get Health Insurance
January 2nd, 2010Health Insurance For Someone With Pre-Existing Conditions
November 10th, 2009
If you have you been rated up or declined for health insurance it’s probably because you have a pre-existing condition.
Thousands of uninsured, underinsured and uninsurable individuals are facing serious health issues like heart disease, heart attack, diabetes, cancer, stroke, liver disease, AIDS, pregnancy, depression and kidney disease. Any of these pre existing conditions can cause them to be declined for health coverage. Today, you may even be declined if you are over-weight.
It’s a real challenge obtaining health insurance for someone with pre existing conditions. However, before we get ahead of ourselves, here are some questions we need to address.
What is a pre-existing condition?
A pre-existing condition is any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within a set amount of months prior to the effective date of coverage (usually 3, 6 or 12 months and this can vary by state). It includes any condition manifesting itself in symptoms which would cause a prudent person to seek medical advice.
What is a pre-existing condition exclusion period?
Insurance companies try to discourage people from waiting until they get sick to purchase medical insurance. This is accomplished by imposing what is known as a preexisting condition exclusion period. This simply means, if you have a medical problem which exists at the time you purchase insurance, the insurer will deny the claims pertaining to that medical problem for a certain period of time.
The rules governing preexisting condition exclusion periods in individual health policies vary widely from state to state and are very much different from the rules of an employer-sponsored plan. If you have or recently have had health coverage, you may be able to apply this creditable coverage to offset a preexisting condition exclusion period.
Why all the hoopla over a pre-existing condition?
The biggest stumbling block with private individual medical insurance is the problem with preexisting conditions. Plain and simple… insurance companies don’t like preexisting conditions. They know in the long run… it will cost them more money to insure you. Frankly, insurers prefer to insure people who are not very likely to need the insurance.
But stop and think! Who doesn’t have some kind of health or medical issue? It may be something as simple as asthma or as complex as cancer. Some pre-existing conditions can be managed and these individuals can live a relatively healthy and normal life.
Yet, insurers can and do turn down “high risks” individuals for coverage because of an existing or previous illness. Even if coverage is found, the premiums charged are often unaffordable. Sometimes the individual may end up with a modified policy paying more because of their medical history or having to take a policy that excludes their pre existing conditions.
Are there things I can do to get healthcare coverage?
Here are some choices for obtaining health coverage. See if any apply to your situation.
(1). Employer-sponsored group health plan
(2). Join a professional organization (e.g. Chamber of Commerce)
(3). Individual health insurance
(4). State risk pool (if one exist in your state)
(5). Discount health cards
(6). Guaranteed Issue Health Insurance
Whether covered by insurance or by some other means, the total cost of health insurance for someone with pre existing conditions is high enough to dramatically impact that person’s lifestyle.
Today it is important for all of us to lead a healthy lifestyle. However, if you already have a preexisting condition that is keeping you from getting affordable health coverage, you should investigate the 6 options listed above to see which would work best for you.
By: Rudy Wilson