ObamaCare Pre-existing Conditions
No More Pre-existing Conditions as of 2014
ObamaCare eliminates pre-existing conditions starting 2014. No more pre-existing conditions means you can't be denied coverage, charged more, or denied treatment based on health status. Considering in 1 in 2 Americans has a health condition that qualifies as a pre-existing condition ObamaCare doing away with pre-existing conditions is a big deal.
According to the CDC, 75 percent of all healthcare expenditures go toward treating chronic diseases, many of which are preventable.
Chronic diseases cause 7 in 10 deaths each year in the United States.
About 133 million Americans—nearly 1 in 2 adults—live with at least one chronic illness.
ObamaCare means no more pre-existing conditions: Being sick or having been sick in the past can no longer can keep you from coverage.
What Does ObamaCare Do For Sick People?
If your currently sick, or have been sick in the past the Affordable Care Act, ObamaCare, is a big deal. Let's take a quick look at some of the key provisions that ensure that people with preexisting conditions get the help they need:
• Insurance companies can't deny coverage or charge more for people with preexisting conditions
• Insurance companies can no longer deny you for any reason other than fraud.
• Insurance companies can't put lifetime or annual dollar limits on Essential Health Benefits which include screenings, preventions, and treatments for most life threatening sickness such as cancer.
• All plans cover free wellness and preventive services. There is no longer a reason to put off doctor visits meaning early detection will help stop sickness before it starts and early treatments will help treat people before its too late.
• Subsidies are available for those who make less than 400% of the Federal Poverty Level. This helps to make both premium costs and out-of-pocket costs more affordable.
Note: The benefits, rights, and protections offered to those with preexisting conditions only apply to plans that have to comply with the ACA. If your plan was issued before 2014 and would have faced cancellation in 2014 but the "fix" to keep your plan until 2015 was put in place it may be exempt from any or all of the above.
How Does ObamaCare Help People With Cancer?
If you or a loved one has cancer or is at risk then the Affordable Care Act offers some pretty ground breaking new benefits, rights, and protections. Check out this PDF on ObamaCare and Cancer.
Preventing Chronic Disease
While certainly not every preexisting condition is preventable, many are. Chronic diseases are the most common and costly of all health problems, but they are also the most preventable. Four common, health-damaging, but modifiable behaviors—tobacco use, insufficient physical activity, poor eating habits, and excessive alcohol use—are responsible for much of the illness, disability, and premature death related to chronic diseases. By ensuring that all Americans are covered and have access to preventive care and treatments, and by focusing on health and wellness, we can improve the health of our nation while driving our health care costs down.
Pre-existing Conditions and the Mandate to Buy Insurance
The reason people were denied coverage and treatments or charged more in the past was very simple, treating sick people is expensive. The higher the risk a customer is, worse deal it is for the insurance company to cover them. Taking this into account insurance companies and legislators made a sort of deal. Health insurance companies would agree to cover everyone and give them all the same essential health benefits, but in return everyone who was able to afford insurance would have to buy insurance.
Everyone must obtain insurance by 2014 or pay a fee. Learn more about the ObamaCare Individual Mandate.
Think about it. If no one could be denied coverage for being sick and didn't HAVE to buy insurance then everyone would just wait until they were sick to buy insurance. If that happened then insurance companies couldn't afford to stay in business then no one would be able to afford healthcare.
The following video explains how ObamaCare affects costs for Americans with pre-existing conditions:
Addressing Insurance Costs Not Health Care Costs
About 60% of bankruptcies in the U.S. are medical related and many of these individuals had health insurance at the time of bankruptcy. Although ObamaCare does a lot to regulate the health insurance industry to ensure that more Americans have access to affordable quality health insurance, it doesn't fully address the underlying issue of the high costs of healthcare in the first place. Luckily knowing you must be covered and can't be dropped addresses the human side of the issue, our right to healthcare.
Beyond Covering Pre-existing Conditions
The trade of the mandate to buy insurance for the mandate to cover everyone is one of the foundations of the entire Affordable Care Act. Along with the right to treatment and coverage Americans also get a number of new benefits, rights and protections that are discussed in detail on our site. They include but are not insurance companies not being able to drop you when you are sick or if you make an honest mistake on your application, insurers not being able to charge women more than men and a number of new free preventative and wellness services that are included with all health plans stating after 2014.
Medicaid, CHIP, Medicare and other insurers are included in the mandate to cover per-existing conditions.
One exception: Grandfathered individual health insurance plans
The only exception is for grandfathered individual health insurance plans--the kind you buy yourself, not through an employer. They do not have to cover pre-existing conditions.
If you have one of these plans you can switch to a Marketplace plan during open enrollment and immediately get coverage for your pre-existing conditions.
What is a Grandfathered Plan: A group health plan that was created—or an individual health insurance policy that was purchased—on or before March 23, 2010. Grandfathered plans are exempted from many changes required under the Affordable Care Act. Plans or policies may lose their “grandfathered” status if they make certain significant changes that reduce benefits or increase costs to consumers. A health plan must disclose in its plan materials whether it considers itself to be a grandfathered plan and must also advise consumers how to contact the U.S. Department of Labor or the U.S. Department of Health and Human Services with questions.
Since customers with pre-existing conditions weren't able to enjoy their new rights to coverage until 2014 ObamaCare created something called PCIP in the meantime. PCIP runs through 2017, but new enrollments are closed. Go here to learn more about the 17 State's that offer temporary coverage to high-risk consumers https://www.pcip.gov/. Even though PCIP enrollment is closed you may still have options.
If you have been denied health coverage you can use the marketplace to buy insurance for 2014. The following video will explain what people could have done in the meantime:
Ensuring More People Buy Insurance
In order to ensure that more people could buy insurance ObamaCare created State specific marketplaces where Americans making under 400% of the Federal poverty level can purchase subsidized regulated insurance that meets the new standards of Obamacare. These are called health insurance marketplaces.
Getting Health Insurance the Covers Pre-existing Conditions
Getting health insurance that will cover your pre-existing conditions is as easy as filling out an application for your State's health insurance marketplace during open enrollment Open enrollment. Find out more about your State's Health Insurance Marketplace here.
If you would like to shop for health insurance that isn't sold through the marketplace then make sure the plan you buy covers essential health benefits, pre-existing conditions, and meets the requirements for minimum essential coverage to ensure you get the same quality health insurance as the rest of us.