Pre-Existing Condition Insurance: The Different Types Explained

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Are you confused about preexisting condition insurance plans? If so, don’t fret, many people feel the same and this page will help you get your head around the topic. So read right on.


There are two main types of pre-existing condition insurance plan:

1. Public Pre-Existing Condition Insurance Plans

The first is provided by your state or the federal government and is specifically for people who have not had health insurance for at least six months and who can’t get insurance elsewhere, including from their employer, an individual plan or Medicare. In these plans you have to pay a monthly premium and make co-payments. If you cannot afford a government preexisting condition insurance plan you may be eligible for Medicaid.


There are three government plans available, all of which give you access to certain providers in their network. This means you may not be able to use your preferred doctor but you will still be able to see a doctor. The premiums, deductibles and co-pays vary by plan, but all pay completely for preventive care. Primary, specialty and hospital care are available to you after you pay a deductible and at a cost to you of 20% of the total price. Prescription drugs are available under the same deal.


These plans are temporary and will expire in 2014, assuming Obamacare is not repealed. After the first of January of that year, insurance providers will no longer be able to discriminate based on pre-existing conditions and so other options will become available to you.


The costs of these plans vary by state, normally somewhere between $100 and $500 a month. To find out the specifics and apply, visit pcip.gov.

2. Private Pre-Existing Condition Insurance Plans

The second type of plan is provided by private companies. The quality, price and level of cover of these plans vary immensely. Some are offered by reputable companies, others by fraudulent ones who may not make good on their promises.


Limited indemnity

The main type of plan we offer for pre-existing conditions are limited indemnity plans. Limited indemnity plans have certain limits. For example, policies will only pay out up to a certain amount and only for certain products and services. In general, the more you pay for a limited indemnity plan the greater level of cover you will receive.

The major benefits of these kinds of pre-existing condition insurance plans are that:

  • They are guaranteed issue – meaning you will not be refused cover.
  • They tend to be cheaper than other types of insurance with polices starting at $30 per month. However, you will also receive less cover. This may not be a bad thing if you do not need as much cover as other plans provide.

With these plans it is important to check the limits, especially those relating to your preexisting condition. You can get a quote for a limited indemnity plan from a local insurance agent by filling out our online form.


In general these plans offer discounts on health care services and prescription drugs for certain treatments, from certain providers, in a similar manner to government issued pre-existing insurance plans.


Fraudulent plans

When getting your preexisting condition insurance from a private company, always do your research. It is wise to check the particular policy you are considering by typing the company and plan name into Google with words like complaint and scam to see what comes up.


Many plans out there make amazing claims about what they offer, but when it comes down to it they don’t actually pay out. Don’t get fooled by offers that seem too good to be true. Fraudulent pre-existing condition insurance plans often use the same terminology as real polices to trick you into thinking they are legitimate. The worse thing about the plans is that the people who have bought them think they are covered. They then run into serious problems when they try to make a claim and it keeps getting denied. These companies will often make it impossible for you to speak to one of their employees about your problems.


You can also check policies and providers with the Better Business Bureau or with your state’s Department of Financial Services or Office of Insurance Regulation.


Discount medical cards

As with limited indemnity insurance, discount medical cards can be both legitimate and fraudulent.


Legitimate cards are available to those looking for pre-existing condition insurance from some providers, including Medicare. These cards can provide discounts on certain healthcare products and services and are especially suited to those who can’t get access to, or afford, adequate cover elsewhere.


Some cards charge high fees to gain access to the benefits they offer. It is always worth calculating whether the benefits of the card outweigh the costs you will have to pay.


You can use the same checks mentioned for limited indemnity insurance to check whether your discount medical card is real or fraudulent. One of the major problems with these cards is that they often advertise themselves as insurance when in fact they are not. This can make it very confusing for people looking to purchase pre-existing condition insurance.


Never drop your current health plan for a discount medical card until you fully understand what is being offered and have checked out the provider thoroughly. If you discover a fraudulent company, report them to the Department of Financial Services, the Office of Insurance Regulation and the Better Business Bureau.

 

If you would like to get a quote for pre-existing condition insurance, complete the form at the top and you will be talking with a licensed insurance agent within minutes.

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