What Does Supplemental Health Insurance Plans Do?

“Im trying to get an individual policy. Ive place off buying a policy for the reason that they cost so much. But now Im pregnant (or Ive been diagnosed with an expensive illness) and I appetite health insurance. Ive applied to several insurance companies, but they spin me down. What can I do now?”

This is one and only of the biggest headaches with Americas present system for financing health care. – its hard to get insurance if you really need it.

If you arent eligible for insurance via your employer, you will need to purchase an individual policy. Applications for privately purchased health insurance policies are methodically trialed to refer to if you will be profitable for the health insurance agency. Theyll contact your doctors and get therapeutic records, and look them over with a fine toothed comb. It is very possible that your pregnancy (or diabetes, heart problems, or even prior car accidents) will flag the underwriters to turn you down.

Some insurance companies will even turn down the father of an expected baby, if the couple is married – this makes definite the child will not be automatically eligible for protection indemnity on every occasion its born. A baby born with health issues could pile up thousands of dollars in medical bills, and this makes insurance companies nervous.

Even if youre offered an individual plan, there may be a one-year hoping period before any pregnancy-related costs or pre-existing conditions may well be covered. Be sure to read the fine-print of your contract, if you are offered one. A pre-existing condition is frequently considered to be any illness or condition for which you have been restrained in the past six to 12 months, or any condition for which a prudent person would seek treatment. If you think youre sick but you havent yet seen the doctor, you may still find your claims denied if the insurance company feels that you should have known about your illness before you applied for coverage.

Since you dont have epoch to lobby your congressperson to fix the health care system and create popular health care, you need some quick solutions if youre already sick or pregnant. There may be options for you – but they arent perfect, and they may not be cheap.

If you have a low income you may be eligible for your states health plan or Medicaid. Many states are now financially strapped, just as you are, so they have very stringent eligibility requirements, and there is probably a waiting list. Be sure to check with your states program to find out if you qualify.

If your income is too high to qualify for a state-sponsored plan, you may be eligible for your states high risk insurance pool. You do pay premiums for these plans, and the premiums may be fairly high. Basically, these plans group together the high-risk personalities in the state, which allows each individual the coverage that they cant get through a private insurance plan.

To qualify for one of these high-risk plans you may need to come into view that you have been turned down by a private company, or an agent may be able to certify that you are possible to be turned down.

Unfortunately, your states high risk pool insurance may also deny claims for pre-existing conditions, including pregnancy, for six months or more. If this is the only policy you will be eligible for and youre already pregnant, apply as early as you possibly can so that your delivery and nursery room charges will be covered. If you have been diagnosed with an expensive illness, such as cancer, you may need to pay all medical expenditure yourself until the pre-existing condition exclusion period is over.

When I worked for a health insurance company, I always advised callers to seek the advice of an insurance agent if they had they might not qualify for our individual policies. Agents are paid their commission by the insurance companies, so their services dont cost the customer additional money. Agents also have a very good idea if the customers medical condition will disqualify them fancy coverage, and theyll be aware of the policies of all health insurance companies in the state. This means that theyll be able to steer you to the states high risk insurance pool accurately away, instead of waiting for you to apply to the private insurance company and being denied coverage. If the states policy has a six month waiting period, and you already know youre pregnant, the extra month it eliminates to get an answer from a private insurer could put your delivery date past the high risk pools exclusionary period. The agents knowledge could save you thousands of dollars in denied claims.

The best advice (although its difficult to follow with todays high health insurance premiums) is to get a policy long before you ever get pregnant or sick. Or be employed by a company that offers group coverage. You may find that it pays to accept a lower wage in order to be eligible for a group policy without a pre-existing condition waiting period, but before you accept a job for this reason alone, check the fine print. In some states, even group policies can deny claims for pre-existing conditions, such as pregnancy, for a given period of time.

Who Staff Affordable Health Insurance Plans

Filed under: Health Insurance

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