Solutions to Make Better Decisions with Your Money

6 Things to Know About Pre-Existing Conditions and Health Insurance

6 Things to Know About Pre-Existing Conditions and Health Insurance - TaxACT

You’ve heard by now that health insurance companies can no longer deny you coverage because you have a pre-existing condition, thanks to the Affordable Care Act (ACA).

That sounds like good news, and for many people it is.

It’s not quite that simple, however.

Make sure you understand the new rules for pre-existing conditions:

You can’t buy insurance on the way to the hospital

It takes time – sometimes weeks – to apply for and get health insurance. Besides, if everyone could wait until they’re being loaded onto an ambulance gurney before they signed up for insurance, why would anyone buy it ahead of time?

You can’t buy insurance through the exchanges any time of the year

If you’re buying insurance through the exchanges (also known as marketplaces), you can only do so during open enrollment periods.

The current open enrollment period ends on March 31, 2014.

The proposed open enrollment period for coverage in 2015 begins November 15, 2014.

You may be able to buy insurance on the exchanges outside of open enrollment periods when you have a qualifying life event, such as marriage, divorce, change in income level, or move to another state.

Grandfathered individual health plans may not cover pre-existing conditions

If you have one of the health insurance plans that you are allowed to keep, these plans are not subject to the rules on pre-existing conditions.

Health care sharing ministries generally don’t cover pre-existing conditions

Although health care sharing ministries, such as Medi-Share, are not defined as insurance, the ACA rules state that you are not subject to the tax penalty for not having insurance if you are a member.

However, you may not be accepted as a member if you have pre-existing conditions.

Short-term health insurance plans, often used for people between jobs, generally do not cover pre-existing conditions

Short-term health insurance plans are not considered adequate insurance coverage under the Affordable Care Act, so you may still owe a penalty despite paying premiums.

Age is not a pre-existing condition

You can’t be charged more or denied health insurance based on a pre-existing condition, starting in 2014. However, you can be charged more for being older.

As a general rule, people use more health care services as they get older. The ACA lets insurance companies charge more to individuals based on their age.

If you have a pre-existing condition, the new rules mean you can get health insurance coverage, even if you have diabetes or other health problems – now or in the past.

The rules don’t mean it’s a good idea to wait to get health insurance.

Going without insurance is still taking a huge risk with your health and your finances. Know the rules, and make sure you and your family can always receive the health care you need.

Have you ever been denied insurance because of a pre-existing condition?

Photo credit: Lincolnian (Brian) via photopin cc

Subscribe to the TaxACT blog and take ownership of your finances!




Take the conversation further...
We'd love to know your thoughts on this article. Meet us over on Facebook, Google+ or Twitter
About Sally Herigstad

Sally Herigstad is a certified public accountant and personal finance columnist and author of Help! I Can't Pay My Bills, Surviving a Financial Crisis (St. Martin's Griffin). She writes regularly at CreditCards.com, Bankrate.com, Interest.com, RedPlum, and MSN Money. She is an experienced speaker and a member of Toastmasters International. Follow Sally on Twitter.