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Pre-existing Conditions are Covered. Period.

Fear is a funny thing. Almost always unfounded.
Otherwise, it would be risk.
Let's talk about our health insurance fears.

Whether you are enrolling into individual health insurance (during open enrollment) or purchasing a group health insurance plan, you cannot have pre-existing conditions excluded from coverage. The carrier must allow pre-existing conditions to be covered. 

So what is the fear in this case of individual health insurance?

Well, one fear happens if you try to enroll in the individual health insurance market outside of open enrollment without a change of status (since a change of status creates a mid-year open enrollment). The carrier cannot deny coverage for pre-existing conditions. However, they can deny coverage. That is a real problem, not merely a fear. Here would be an example: you have individual coverage, and you let it lapse. You cannot enroll again, expect during open enrollment (November 1 - December 15).

So you have NO coverage. Regardless of whether you need care for a new condition of a pre-existing condition. 
Answer: do not let your individual coverage lapse.

Another fear might be concerning group health insurance: if you implement a group health insurance (whether the employee has current coverage or no coverage) will the plan cover pre-existing conditions? The answer is: yes, the group plan will cover pre-existing conditions.

Most importantly, unlike individual health insurance, you can buy group health insurance anytime of the year.
There is no government enforced open enrollment period for group insurance.
You can implement or change a group health insurance - anytime.

Let's review: both individual health and group health insurance cover all pre-existing conditions.
Individual health insurance has an open enrollment period: November 1 - December 15.
Group health insurance's open enrollment is the month that plan is purchased or renewed.

As with anything in life, there are exceptions:
A change of status (birth, death, divorce, loss of job, etc.) creates a special open enrollment period (both individual and group).
A significant change in employer health insurance coverage or contributions also creates a special enrollment period.

Lastly, if you miss open enrollment, a few states do allow short term health insurance.
The coverage is underwritten, and does not cover pre-existing conditions.
But it may be available. Learn more.

Confused? Don't be.
Just call us, and we can help.

Topics: health insurance, pre-existing conditions