Health insurance is designed to help cover policyholders when they become ill or injured and need to pay for medical procedures, treatments and examinations. There are many different types of health insurance plans which are changing constantly under legislation and market forces. Two of the most common are group health plans, offered by employers, and individual health plans. Preexisting conditions, or long-term medical conditions such as diabetes and cancer, can limit what coverage policyholders can qualify for under most policy types.
Waiting Periods
Insurers do not want to lose money. If they offered coverage for all preexisting conditions immediately, then patients could switch to a high-paying policy when they are diagnosed and have their medical expenses taken care of at low costs to them. However, legislation often limits what conditions insurers can definitively refuse coverage for, so instead, insurance companies institute waiting periods. These periods can last anywhere from several months to a year during which time the policy will not cover preexisting conditions.
HIPAA Regulations
HIPAA stands for the Health Insurance Portability and Accountability Act, legislation that has far-reaching effects on all health insurance. Under HIPAA, if policyholders meet certain criteria with regard to their illness and financial status, they can switch from one policy to another and get immediate coverage for their preexisting conditions without going through a waiting period. There is a catch: policyholders must switch from one group plan policy to another without a lapse in coverage. Moreover, immediate activation is not available if the individual is using private insurance.
High Risk Insurance
High risk insurance is specific health coverage for specific conditions. This insurance is used to help cover the high costs of issues, such as cancer or complex surgery. The policy is designed to cover these conditions once they are likely and does not come with waiting periods, but insurance companies still want to make a profit and will include caveats for certain expenses. Premiums for high risk insurance are also very high.
Government Programs
Government programs exist to help patients pay for expensive medical treatment that their policies may not cover. These programs vary by state and may work through clinic subsidies or state-sponsored insurance. States may also offer their own versions of high risk insurance and similar programs.
Tags: preexisting conditions, Health Insurance, health plans, help cover, high risk insurance, insurance companies, policy another
