The Pre-Existing Conditions Conundrum

There are times that finding an Illinois health insurance plan suitable for a pre-existing health condition is difficult, if not next to impossible. What do people do about that?

The first thing to understand when dealing with Illinois health insurance is what the definition of a pre-existing health condition happens to be. To simplify a sometimes long and drawn out description, a pre-existing condition is one where a person has seen a doctor and has been diagnosed with a “condition or illness,” and has been treated prior to applying for Illinois health insurance.

The tricky situation then becomes the fact that many Illinois health insurance companies use the application questionnaires to implement an exclusion period to defend themselves against people with pre-existing health conditions. It is often used as a loophole to deny insurance, rider it or accept it, but with a higher premium.

The conundrum in Illinois is that if a person is looking for individual Illinois health insurance and they have a pre-existing condition, the insurance company can turn them down unless the person happens to be eligible for an Illinois Health Insurance Portability and Accountability Act, HIPAA. Without getting too technical, HIPAA protects Illinois health coverage for workers and their families if they change or lose their jobs and provides protection for those with pre-existing medical conditions by limiting their exclusion period.
While it’s a good thing to have that law in place to protect people who need Illinois health insurance, the unfortunate thing is that the law hasn’t gotten rid of the ability of insurance companies to deny health insurance to those with pre-existing health conditions or even excluding medical conditions. What this boils down to is that there’s only guarantee issue in State sponsored plans and in insurance company funded plans. If an applicant for Illinois health insurance meets six HIPAA criteria, they are eligible for guaranteed issue HIPAA. In a pinch, this may be the only route those with major pre-existing health conditions are able to take.

Illinois health insurance companies all tend to handle pre-existing health conditions differently, so it’s best to do some serious research online and in person to find out what company and policy will be applicable. It’s a given that individual plans have more exclusions and are more expensive than group plans. When in doubt, ask a local insurance agent what is available and what the requirements are to apply.

Some of the most important insurance companies in the state of Illinois handle pre-existing conditions a little bit differently, because of this it is important to do some research and actually shop around for a policy before deciding to apply. Individual plans have more exclusions than group plans and that is why they are quite a bit less expensive, because they are more restrictive.

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