Those needing health insurance for individuals with pre existing conditions should be sure that they don’t take the first “no” as their final answer. They may pay more than they should if they take no for an answer or accept the first costly option. Not all insurance companies treat every condition and individual the same way.
An individual who believes that they have a pre existing health condition that will affect their ability to enroll in an insurance plan should first verify that their condition is a problem with all the plans available. Even if one or two medical insurance companies considers them a high risk or denies coverage, they should not assume that a second or third company will do the same.
Special Rules for Children with Pre Existing Conditions
Although there are certain conditions that adults will be denied for when they apply for any underwritten policy, this isn’t the case with children. The recent health care reform mandates changes this. As of September 23, 2010 (with few exceptions) a child who applies with a parent cannot be denied based on their medical history so long as one parent is approved for coverage. This is also the case when an individual applies through their place of business for a group health insurance policy with their child.
Adults with Pre Existing Medical Conditions
Health insurance companies do not all have the same underwriting guidelines. Each is a separate business and they will often assess the risk of insuring an individual differently. For this reason a person diagnosed by their provider with high blood pressure and high cholesterol, might be turned down based on their preexisting conditions when they apply for enrollment in a policy offered by one company. A second company may think that that person is a high risk, but approve their application but ask that they pay higher premium. A third company might not consider them a high risk at all and will approve that person for any of their plans with a standard premium.
Different companies will have different height and weight guidelines and therefore different opinions regarding whether an individual obese or whether they are just heavier than the average person and therefore will be willing to accept the risk of insuring that person. These differences apply to more serious preexisting conditions as well. Pre existing conditions like cancer, diabetes and heart conditions are treated differently by different insurance carriers.
You have to shop around not only for price and coverage, but also for the most favorable underwriting decision. Working with an agent who knows the health care insurance landscape in your area can go a long way towards making the experience of shopping around for health insurance less consuming and less of a hassle. An agent may be able to keep you from paying more than you should.
This is especially true when looking for private medical insurance for an individual with a pre existing conditions. Finding access to affordable health insurance means gaining affordable access to otherwise costly providers that can make a difference in the quality of your life.
I was about to end this series about selling health care insurance across state lines but then a picture of my local bank popped into my head. The reason why this picture made me think is that the bank isn’t there anymore.
None of the local banks are around anymore! Why? They deregulated the nation’s banks about twenty years ago. (Banks were not allowed to cross state lines before then.) Do you remember small local banks? Are any of them still in your area?
The big banks gobbled up the small banks and the bigger banks gobbled up the big banks once they were allowed to open branches in other states.
My fear is that allowing our federal government to reduce regulation on the insurance companies will have the same impact on the industry as deregulation had on the banking business. Our coverage options will diminish, but eventually we will forget the smaller insurance companies just like we’ve all but forgotten the smaller banks that used to compete in our market.
It is entirely possible that this simplistic idea will result in less competition in the health insurance industry and not more. More competition resulted in less competition in the banking business.
Why won’t it do the same to the insurance industry? Will we wind up with fewer insurance companies to choose from when we need insurance coverage for health care?
If we allow the federal government to do this, who wins? The biggest insurance companies win. Who loses? You and I lose.
Allowing American health insurance companies to more freely sell across state lines could result in higher prices for those who need it most! I know that we have heard politicians on the news stating just the opposite time and time again, but I sincerely believe that they are wrong.
Although with proper regulation, additional competition can result in lower rates for all, unbridled competition could result in the destruction of our private health insurance system and real damage to those who have medical conditions. Deregulation won’t be good for business owners nor will it be good for consumers.
Why? A new company is likely to attract a disproportionate number of younger and healthier policyholders. This means that they will be able to charge less and they will be able to get more business.
Isn’t this a good thing? It could be, but it could also backfire in a big way.
The following is not based on my view as a Democrat or a Republican, but my view as an experience as an insurance agent who has been around the block a few times.
Health Care Reform Has Already Hurt Children!
It could backfire just like their mandate that was supposed to force the American health insurance companies to insure all children already has. You may want to watch my video about how health care reform is hurting children.
Have you had a chance to view this information on the news? Are the politicians working feverishly to correct their mistake, or is it being swept under the rug.
Once the older established companies enough of their healthier clients to the new company, their rates will go up very rapidly over a short period of time. The older and sicker policyholders may not have the option of switching to the new company and they get hurt by deregulation.
The new company can come into the state and offer a low price but not lower the average cost of insurance! Moving into the new state will be a good business decision for the new insurance company.
However it will not create a better situation for the average policy holders of that state. Although the healthier policyholders who are able to switch may benefit for a time, the sicker policyholders may get be forced to pay more and more and more. Their premiums may go up to the point where their coverage is completely unaffordable.
I’ll give you one big reason why allowing health insurance companies to sell across state lines won’t solve our problems: They are already selling across state lines!
Although Connecticut has only 1.5% of the nation’s population we have a significant amount of competition in our health insurance markets. We have 8 companies competing in the individual medical insurance market. We have 17 health insurance companies that compete in the group medical insurance market.
Almost all of the companies sell in multiple states. We have a Blue Cross Blue Shield franchisee. We have a United Health One subsidiary (formerly United Healthcare). Aetna and Cigna also sell in Connecticut.
The issue has been misrepresented by many people who are supposed to know what they are talking about. The issue isn’t whether or not insurance companies should be allowed to sell across state lines. The issue is about taking the states power away and making it easier for the insurance companies to sell across state lines.
Insurance companies want to get approval from one regulatory body and then be allowed to sell across the country. Allowing companies to do this will increase competition in theory, but in my opinion it will backfire in the long run.
This issue is smoke screen at best. And at worst it is part of a conspiracy to make the rich insurance companies richer and the rest of us poorer.