Choosing a health insurance plan can be challenging even for people with uncomplicated health needs. If you have a pre-existing condition or chronic illness that requires frequent maintenance, it’s even more confusing. Will you even qualify for health insurance? And will you be able to find a plan that suits your very specific needs?
We believe that everyone deserves excellent and affordable healthcare policies, no matter what their medical condition. That’s why we’re here to take the guesswork out of choosing the health insurance policy that’s right for you. Keep reading as we cover the ins and outs of health insurance for pre-existing conditions and chronic illnesses.
Thanks to the Affordable Care Act, also known as Obamacare, insurers can no longer deny you healthcare coverage or charge higher rates if you have a pre-existing condition. It’s also illegal for them to charge more if you develop a chronic medical condition while enrolled in a health plan.
There is, however, one important exception. The Affordable Care Act (ACA) was signed into law on March 23, 2010. As a result, these pre-existing coverage rules do not necessarily apply to “grandfathered” health insurance policies. That means that if you bought a policy for yourself or a family member on or before this date, it was sold directly through an insurance company, agent, or broker, rather than the Health Insurance Marketplace—the health insurance shopping and enrollment service created by ACA. Therefore, your plan may not include some of those rights and protections provided under the Affordable Care Act.
Not sure if your plan is grandfathered? Your insurer is legally required to notify you about this status. You can also check with your insurance provider or speak with a benefits agent for the details of your health plan.
So what happens if you purchased your current health insurance plan before the ACA was implemented? Thankfully, there are several ways you can drop the grandfathered status of your policy to ensure that you have the same rights as ACA-sponsored plans:
Getting medical coverage for your mental health is just as important as covering your physical health. Fortunately, the Affordable Care Act requires plans sold on the individual and family health insurance marketplace to include mental health insurance coverage, as it’s considered an essential benefit.
The ACA strives to make mental health insurance not just available but affordable, too. That’s why ACA requires insurance providers to cap out-of-pocket spending on mental health costs. It also prohibits limits on annual or lifetime coverage for mental health care.
All Marketplace plans are required to cover these mental health care services:
The extent of your mental health coverage you receive will depend on the details of your specific plan. The higher your plan level, the more coverage you will receive overall. For example, a platinum plan usually offers more benefits than a gold, silver, or bronze plan. However, if you use or plan to use mental health services often, a plan type with lower out-of-network costs, such as a PPO plan, might be your best option. A PPO plan will allow you to see providers out of your network, while maintaining coverage for your services.
Generally, plans with higher premiums offer more coverage for services. Plans that allow you to use providers outside the network may also cost more, while short-term plans designed to cover you when you are temporarily out of work might cost less.
If you have a standard health insurance plan that doesn’t cover mental health services, you may want to consider changing to a High-Deductible Health Plan (HDHP) that does cover mental healthcare. Many HDHPs can be combined with a Health Savings Account, which allows you to pay the deductible with pre-tax money.
If you’re managing a chronic condition, you know that the expense can really add up—which makes it critical to choose a health insurance plan that will help keep your monthly costs as low as possible.
That’s why your best bet is to choose a health insurance plan through the Health Insurance Marketplace, since all of these plans are required to cover pre-existing conditions. This makes choosing a plan easier, too. Rather than worrying if a plan covers your condition or not, you can focus on the details of what it covers in order to choose the best plan for your needs. Use your provider’s online portal, or speak directly with an agent to ask the following questions:
Healthcare expenses are a priority in any insurance policy, but they’re especially important if you’re chronically ill. That’s because there’s a greater likelihood that you’ll actually hit your out-of-pocket maximum (the limit of money you have to pay before your health plan will cover the rest). A low-deductible plan has higher premiums, but it also makes health care costs more predictable. That’s why it’s often the most financially wise choice in the long run if you require frequent doctor’s visits or hospital stays.
Shopping for a new health insurance policy can feel stressful—but we’re here to make it quick and easy. We offer the best possible coverage rates to help you and your family stay safe and healthy—while also saving money for your future. Best of all, our free online insurance quotes are lightning quick. Get yours now, and say hello to affordable healthcare coverage—in just a matter of minutes!
