Short-Term Health Insurance With Pre-Existing Medical Conditions

How Short-Term Health Insurance Coverage Works For Individuals With Certain Medical Condition

Have you ever wondered what it is like to buy short-term health insurance for an individual with a pre-existing condition? It is unlikely to find insurance coverage especially for people with existing conditions, but as the law changes pre-existing conditions can be covered by insurance but will be limited.

Today, we’ll talk about short-term health insurance for pre-existing conditions. How did it work for them? As we mentioned earlier insurance laws change, people with existing illnesses can buy short-term health insurance but not all enrollees can be accepted. 

Since short-term health insurance is not part of the Affordable Care Act (ACA), meaning they don’t need to comply with their certain standard, and pre-existing conditions are not covered within a short or temporary plan. However, not all pre-existing conditions disqualify you for coverage, there are some certain illnesses that will qualify you for short-term even if you have existing conditions.

Understanding Pre-Existing Conditions

A pre-existing condition is a medical problem or health condition of a person that occurs prior to applying for health or life insurance plans. Chronic illnesses and medical conditions, such as any form of cancer, diabetes, lupus, epilepsy, and depression are examples of a pre-existing condition. Pregnancy before applying for health insurance is considered a pre-existing condition.

Here is some medical condition that can affect your application for short-term health insurance:

• Arthritis
• Asthma
• Cancer
• Chronic obstructive pulmonary disease
• Congestive heart failure
• Diabetes
• High cholesterol
• High blood pressure
• Joint replacement
• Maternity
• Pain constantly
• Profound fatigue

While the lists might seem to limit, noticing that acne and sleep apnea are a few conditions that many insurance companies accept for short-term health insurance. So it is important to remember that applying for temporary health insurance can be denied or if accepted you pay an extra charge or your insurance carrier might not cover your medical treatment that correlates to your existing condition.

 

In addition, the length of time that temporary policies “lookback” for pre-existing conditions may differ by state, in most states, there’s a five-year lookback period for short-term claims. Meaning the third-party provider which will pay for your medical claims, can review your medical record from the previous five years to determine if a current condition is related or connected to your existing illness.  However, in some states, they have a shorter lookback window, if you are a resident of:

 

• Idaho – 6 months
• Illinois – 2 years
• Indiana – 1 year
• Louisiana – 6 months
• Mississippi – 1 year
• North Carolina – 1 year
• North Dakota – 2 years
• Texas – 1 year
• Wyoming – 6 months.

The main benefit of having this coverage is repricing: if you’re uninsured, you’ll have to pay the full rate of your medical treatment while if you have short-term coverage even if the treatment is not covered, your out-of-the-pocket payment is re-priced into a lower amount to give you some financial protection. You should ask first your insurance agent before buying this type of coverage

 

The bottom line is short-term health insurance plans are not for everyone, especially for those with existing illnesses. If you are diagnosed with one of the lists above it can be risky to buy this coverage. But if the coverage you need is for a certain amount of time, it is better to have some coverage than face and pay the full amount for an unexpected medical bill.

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