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Monica | Why does having health insurance before being diagnosed with a serious condition make a difference? |
My toddler has type 1 diabetes. When she was in the hospital right after being diagnosed I had a conversation with one of her nurses. This nurse told me a story about how before she got her job at the hospital her and her husband were temporarily unemployed. She said she had made sure to get very basic health insurance during that time, because if she was diagnosed with something serious without the basic insurance that she would become uninsurable.
Her reason for telling me this story was clear. We were uninsured when my daughter was diagnosed, and she was warning me that there are hard times ahead for us ... in other ways besides the obvious.
But I don't understand how that works. Why does having insurance before you're diagnosed with something make a difference? Are there laws protecting people in that situation? Why can't their current insurance company just drop them, or jack their rates up so high that they can't afford it?
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Graves, you need to read my entire question, not just the first part. |
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Lauren F
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The reason is that many insurance companies have a "preexisting condition" clause that says if you had a medical condition before you bought that insurance, they don't have to cover any costs related to that condition. They do have to cover other problems that arise after you purchase insurance, and cannot discriminate or jack up your rates if you have the misfortune of illness after you buy insurance. But if you are sick before you buy the insurance, they can deny you, or deny coverage for the illness that existed before you bought the policy. For example, if you bought insurance after you found out you had diabetes, they might not cover the diabetes treatments, but if you later were diagnosed with cancer, they would have to cover the chemo treatments.
If you and/or your husband are employed by a large employer, such as a big company or a city/town, then they probably do not have a "preexisting condition" exclusion. So, one way to get insurance for difficult diseases like diabetes is to get a job with benefits with a company who's policy does not have preexisting condition exclusions.
There are also insurance programs for children of low income families that you might want to look into, if that situation applies to you.
Diabetes is a very dangerous disease, and expensive to treat. It is important that you get some insurance for your child.
Best of luck with this, and I hope your daughter does well. |
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gravesforboys
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because then you arent the one paying thousands and thousands of $$$, its your insurance comapny.
my dad always told me that if he didnt have healthcare when my mom was diagnosed with cancer, we would be in serious debt. thanks healthcare! |
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chessale
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Its called preexisting condition. An insurance company is not required to cover a preexisting condition if the patient was not previously insured until certain conditions are met, normally being in the insurance plan for a set amount of time 3, 6, 12 months.
Generally all insurance is a gamble. The company bets you will pay in more than you take out and you bet you will take more out than you put in. If people only paid for health insurance when they were sick the program would go broke immediately. The same with life insurance. You have to buy the plan before you are diagnosed with terminal cancer or plan suicide or you don't get paid.
If you have insurance the law protects you from being dropped or having your rates adjusted if you are already insured and have paid your premiums. In addition, if you have insurance and change to a different insurance carrier, without a break in coverage, the new carrier cannot refuse to cover preexisting conditions. That is also the law. |
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d-lishes
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Insurance companies can refuse to cover you or charge you higher premiums for pre-existing conditions. Diabetes is a pre-existing condition. |
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Insurance Pickle.com
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It's illegal to drop them or jack their rates up. That's why you need to get insurance before needing it.
You can't call Allstate to insure your home when it's on fire AND they can't drop you AFTER they find out it burned down.
Insurance is for UNEXPECTED illness or injury (or in the case of homes...peril).
Your premium is a payment to the insurance company to 'take a chance' on you. That's why bad drivers, unhealthy people, etc.. pay more because the risk is greater.
Good luck with your toddler. I hope you live in a good state that provides coverage at reasonable rates like my state does.
http://www.InsurancePickle.com |
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Custo
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Think about it like this... It keeps people who, for instance, find out they have a serious illness, & buy health insurance to cover them during the duration of the illness only.
Say you were diagnosed with cancer on August 1st. & got health insurance August 2nd. Paid $600.00 per month until the cancer was in remission, & then canceled the insurance.
People need to have health insurance. All the time. Not just when they think they're going to be sick... Having prior health coverage is kinda like a checks & balances system. |
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mbrcatz
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Because once you're diagnosed with something, the insurance company does NOT have to give you a policy at all.
Insurance is regulated on a state by state basis. NO states allow an insurance company to jack up the rates once something is discovered. It's not like car insurance, once they take you, they have to keep you as long as you keep paying the premiums. They can't drop you, they can't surcharge you. That's why they're pretty careful up front, to make sure there isn't something already wrong.
A couple of states have laws that make an insurance company not be able to refuse to cover you. Those are "guaranteed issue" states. But still, there's no limit on how much the insurance company can CHARGE you for that policy. Type 1 Diabetes is SERIOUS. Just the maintenance stuff, is EXPENSIVE. Complications from the diabetes, are very serious. Most private health insurance companies will flat out refuse to give insurance to your toddler now.
So, if you're in a guaranteed issue state, you might get an offer for health insurance for your child, at $2,000 a month. And if you're not in a guaranteed issue state, you'll have to apply for your state High Risk Health Insurance fund. Which can also run thousands a month, and usually has a waiting list.
You probably also want to apply for health insurance for the child, under your state Children's Health Insurance Program. When you identify that the child is effectively uninsurable on a private program, due to the diabetes, many states will insure the child, only counting the CHILD'S income, not the household income.
Unless, of course, you've since added the child to a group health plan through your employer, which is flat out the best way to go.
Short answer: if you don't have insurance in place before the bad stuff happens, no one will give it to you afterwards. |
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HealthQuote360.com
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To respond to a previous poster there is nothing sad about the way our health care system works just like there is nothing sad about the way our auto insurance system works.
Think of it like this: just like you can't total your car and then after the accident call an insurance company to add collision coverage to cover all of the damages you also can't be irresponsible and not purchase health insurance until after something happens to you.
If insurance companies were required to accept everyone that applied for the plan and cover everything right away even if they had big expensive health problems then of course no one in their right mind would purchase health insurance until they developed a major illness. Then of course the rates would be astronomical for everyone.
So just like it is the responsible thing to do to buy auto insurance coverage before you potentially get in an accident it is also the responsible thing to do to buy health insurance coverage before you potentially get diagnosed with a serious medical condition.
That being said, everyone makes mistakes and there are still ways to get coverage even when you have less than perfect health. Here is some more information on finding health insurance even with pre-existing medical conditions: |
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Amy
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It makes a huge difference! If you tried to get insurance after you found out it would be hard because insurance companies don't want to pay up anymore than they have to! If you need an alternative...I know of a great company, just let me know! |
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Really?
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if you dont have insured and are diagnosed, you will be denied coverage most likely because youll become too much of an insurance liability. insurance companies dont want to pay money out for you, they want you to be perfectly healthy. so if you have a pre-existing condition, good luck getting health insurance. better off with minimal coverage. and yes, insurance companies do raise rates so youre no longer able pay, but thats after youve already gotten your medical treatment, so they rather deny you in the first place |
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Yam King 7
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Well, it's a sad truth about our health care system.
In a country that cares for it's people, you'd get health care regardless of whether it was before or after you were diagnosed.
Unfortunately, the system is built to make money for the insurance company instead of looking out for the people.
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