In Pennsylvania, as in most states, there are provisions in place for individuals who fall into the low income bracket. One of those provisions focuses on the need for affordable health care. In this state, there is a program called adultBasic which provides health care insurance for people who earn an income below a prescribed level. For anyone over and above that level, they need to find and purchase their own health care insurance. This means that affordable health insurance is a highly sought after commodity.

There are a few different approaches to finding affordable health insurance in Pennsylvania and they all begin with deciding what level of coverage is needed. This is typically determined by the age and the current health of the insured. If a person is young with no obvious medical concerns, they should have no trouble finding health care at a reasonable cost. For someone more mature who is battling several serious health matters, the likelihood of them finding low-cost health care isn’t as good.

Most people need to begin by securing several quotes for basic health insurance. This type of insurance provides coverage for the average individual’s basic needs. Typically it includes coverage for doctor’s visits, some prescription coverage as well as limited hospital coverage. If someone is ill or has been diagnosed with a serious condition they will need to ask for quotes for a major medical policy.

All health insurance agents want to ensure that they sell a policy to the individuals who contact them for a quote. Therefore you can generally work with an agent to find a policy that provides the type of coverage that is required and fits within your budget. Adding or subtracting options within policies so that they are tailor made to reflect the coverage the individual needs is a great way to reduce costs while not skimping on medical needs.

If you have you been rated up or declined for health insurance it’s probably because you have a pre-existing condition.

Thousands of uninsured, underinsured and uninsurable individuals are facing serious health issues like heart disease, heart attack, diabetes, cancer, stroke, liver disease, AIDS, pregnancy, depression and kidney disease. Any of these pre existing conditions can cause them to be declined for health coverage. Today, you may even be declined if you are over-weight.

It’s a real challenge obtaining health insurance for someone with pre existing conditions. However, before we get ahead of ourselves, here are some questions we need to address.

What is a pre-existing condition?

A pre-existing condition is any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within a set amount of months prior to the effective date of coverage (usually 3, 6 or 12 months and this can vary by state). It includes any condition manifesting itself in symptoms which would cause a prudent person to seek medical advice.

What is a pre-existing condition exclusion period?

Insurance companies try to discourage people from waiting until they get sick to purchase medical insurance. This is accomplished by imposing what is known as a preexisting condition exclusion period. This simply means, if you have a medical problem which exists at the time you purchase insurance, the insurer will deny the claims pertaining to that medical problem for a certain period of time.

The rules governing preexisting condition exclusion periods in individual health policies vary widely from state to state and are very much different from the rules of an employer-sponsored plan. If you have or recently have had health coverage, you may be able to apply this creditable coverage to offset a preexisting condition exclusion period.

Why all the hoopla over a pre-existing condition?

The biggest stumbling block with private individual medical insurance is the problem with preexisting conditions. Plain and simple… insurance companies don’t like preexisting conditions. They know in the long run… it will cost them more money to insure you. Frankly, insurers prefer to insure people who are not very likely to need the insurance.

But stop and think! Who doesn’t have some kind of health or medical issue? It may be something as simple as asthma or as complex as cancer. Some pre-existing conditions can be managed and these individuals can live a relatively healthy and normal life.
Yet, insurers can and do turn down “high risks” individuals for coverage because of an existing or previous illness. Even if coverage is found, the premiums charged are often unaffordable. Sometimes the individual may end up with a modified policy paying more because of their medical history or having to take a policy that excludes their pre existing conditions.

Are there things I can do to get healthcare coverage?

Here are some choices for obtaining health coverage. See if any apply to your situation.

(1). Employer-sponsored group health plan

(2). Join a professional organization (e.g. Chamber of Commerce)

(3). Individual health insurance

(4). State risk pool (if one exist in your state)

(5). Discount health cards

(6). Guaranteed Issue Health Insurance

Whether covered by insurance or by some other means, the total cost of health insurance for someone with pre existing conditions is high enough to dramatically impact that person’s lifestyle.

Today it is important for all of us to lead a healthy lifestyle. However, if you already have a preexisting condition that is keeping you from getting affordable health coverage, you should investigate the 6 options listed above to see which would work best for you.