Pre-Existing Medical Insurance Coverage – How To Buy A Policy

Pre-existing condition medical insurance coverage is harder to qualify for than a conventional policy. But we can help. Individuals and families with pre-existing medical conditions can often purchase coverage, either through normal underwriting or “guarantee issue” plans. Rates, of course, can vary by a wide margin, depending on where you live. And  benefits will not be the same in all areas of the country. That’s why our professional shopping help can save you money.

However, beginning in 2014, pre-existing and chronic conditions will have no impact on the price you pay. Although your smoking status, age and where you live will determine your premium, your overall health status will not be a factor. So, hypothetically, whether you are in impeccable health or are a walking hospital ward, it will not have any bearing on the cost of your medical plan. finds the carriers that offer this type of coverage and makes it easy for you to compare your options. Easily, you can  apply for private coverage here. Simply provide your zip code in the box at the top of this page and soon you’ll be presented with the best choices from reputable companies, including Blue Cross, Aetna, UnitedHealthOne and other regional carriers. Naturally, your rate will depend on a few factors including your age zip code.

What Is A Pre-Existing Condition?

A pre-existing condition is a mental or physical health condition or illness that is present before you apply for a health insurance plan. It also may be a condition that someone has received treatment, consultation,  or medical advice. Also, if symptoms were present, they may be considered a pre-existing condition if treatment should have been performed, but was not. If you are not aware of a sickness, then typically, it’s not considered.

Different Types

Not all types of pre-existing conditions will impact your cost. For example, conditions such as high blood pressure, anxiety, high cholesterol, asthma, allergies, depression and acid reflux are not likely to cause a denial for coverage. If coupled with other conditions, a denial for medical coverage is possible, until 2014.

And if coupled with a high BMI (Body Mass Index), a denial becomes more likely. Each insurer can interpret  the BMI numbers indifferent ways. Sometimes, one company will offer a policy while another will reject the same application.


For example, if an applicant takes medications for high blood pressure and high cholesterol, and also is obese, they most likely will be denied coverage. Also, typically, most forms of cancer (not necessarily skin cancer), diabetes, pregnancy and heart disease will cause an application to be rejected. Also, rheumatoid arthritis, epilepsy and muscular dystrophy will all likely cause a denial in coverage. However, if these conditions were once present and now no longer exist, the underwriters will view this favorably.

How To Qualify For Health Insurance

As previously mentioned, many applicants qualify for coverage with pre-existing conditions. For those persons that do not qualify, each state has a “Risk Pool” that has been established through the “Patient Protection And Affordable Care Act.”  A “Pre-Existing Condition Insurance Plan” (PCIP) is now available to persons that have been uninsured for at least six months. And every state offers this coverage. Low cost medical insurance is often available even if you are currently being treated for a condition. Pennsylvania’s rates, for example, are very inexpensive (about $250-$300 per month). However, each state will charge different rates. Smoker rates are typically higher than non-smoker rates.

How Does The PCIP Work?

The PCIP was created to help individuals that have had trouble obtaining health insurance coverage. The PCIP plan provides comprehensive medical coverage and does not charge a higher rate because of pre-existing conditions. To qualify for coverage, some of the requirements include:

1. You must have been uninsured for the last six months.

2. You must have had difficulty buying health insurance.

3. You must be a citizen of the United States or living legally here in the US.

4. You must show a copy of a letter from an insurance company within the last six months denying your application or excluding your medical condition.

What is HIPAA?

The Health Insurance  Portability And Accountability Act (HIPAA) was enacted by Congress in 1996. It was designed to provide protection for persons that are purchasing, altering or continuing their health insurance coverage. Some of the important articles of the Act include:

  • Guarantee of renewability of your health insurance regardless of individual or family health conditions.
  • Pre-existing condition exclusions are limited.
  • Prevents many medical insurance plans from denying coverage or raising premiums due to health problems.

HIPAA also considers “credible coverage” when determining pre-existing condition exclusions. Credible coverage is defined as health insurance benefits that were in effect without more than a 63-day break in coverage. This coverage can be used to preclude pre-existing condition exclusion periods that may be contained in a new health insurance policy. “Limited Benefit” plans are generally not considered as credible coverage, since they typically have large gaps in benefits.

We built this website so you could quickly apply online for quality pre-existing medical insurance coverage from the top companies. We understand the application process can be quite tedious and time-consuming. That’s where we can help. Simply provide your zip code at the top of the page to begin the free quote process. There is no obligation at any time.

The Supreme Court ruling upholding The Affordable Care Act will make qualifying for a policy much easier in 2014. Children  under the age of 19 will have more options in 2014 also. Quite simply, all persons (assuming they are US citizens and meet a few simple requirements), will not have to worry about what pre-existing conditions they have or had in the past. There may be open-enrollment periods, although it is still being discussed.

Update: 9-28-2013  Open Enrollment has arrived (actually on October 1st) and  policies issued in 2014 will require that no medical questions  be asked and pre-existing conditions will be covered. Also, the federal subsidy will pay up to 100% of premiums (if you qualify) and drastically reduce rates for millions of Americans.

State Marketplaces will open on October 1st, and we will continue to offer the lowest available rates through our free quotes. Individuals and families with current coverage will be able to keep “grandfathered” plans. You will receive notification from your current company regarding the status of your policy.