Health Care Reform
Most people agree that health care reform is desperately needed. The debate continues about the current plan enacted and its long term costs and effects. There are numerous online articles addressing the National Healthcare Bill and there are several questions regarding the bill that need to be addressed. One concerns preexisting conditions. What does that mean? When does it go in effect? What effect does it have on me and my family members?
A preexisting condition is any medical condition for which you have received treatment for an extended period of time. The definition of a preexisting condition varies by state but, in general health insurance policies exclude coverage for conditions that have been diagnosed or treated within the previous 12 months to 24 months, depending upon the company and policy. Check the companies’ preexisting conditions clause for more specifics. For instance if you take medication on a daily basis for any condition such as thyroid, blood pressure or cholesterol, you have a preexisting condition. These examples are used since these are the conditions for which most commonly prescribed medications are given. More severe conditions such as cancer, chronic kidney diseases and heart conditions are more obvious and not specifically discussed in this article.
The exclusion of preexisting conditions goes into effect for children on September 23, 2010. The biggest question then is at what age does this cover? Is it 18 as most people believe or is it 26 since this is in the same time line the inclusion of children under their parents existing health insurance policy goes into effect? This needs to explored for a definitive answer. The rest of the population will be covered for preexisting conditions in 2014 as the bill now stands.
There will be no waiting periods or exclusions for those conditions that develop according to the legislation passed. If a child becomes ill prior to September 23, 2010, and they apply for coverage after that date, this will be a salvation for the family because the out-of-pocket expense drops dramatically. If a child develops a condition later and the parents lose their current coverage, future coverage cannot be denied by another insurer. If an illness or accident requiring long term care happens to a child between the ages of 18 and 26, are they going to be covered as well? This point needs clarification.
The largest portion of our society falls under the exclusion of preexisting conditions until 2014. Unfortunately, this is the segment of the population most likely to develop preexisting conditions as defined by the insurance industry and the National Healthcare Bill recently passed. Most people are not aware that for some reason thyroid conditions have increased dramatically over the last decade and thyroid medication has become the number one prescribed medicine in the country. This is followed closely by medicine to reduce blood pressure and cholesterol lowering drugs. These three conditions are life threatening if not treated. The cost of doctor appointments, necessary laboratory tests needed to monitor these diseases and the cost of the prescription drugs can be a burden on anyone. Fortunately the advent of $4.00 generic brands has lowered the cost of the medication but not the doctor visits and laboratory fees.
Without health insurance coverage, before the exclusion takes effect, the medical costs can become prohibitive for those caught in the middle. Those not qualifying for government programs, people working part-time jobs, the rising number of contract employees who do not qualify for health coverage or those working where benefits are not offered are the hardest hit by these costs. Additionally, the high number of people that have lost or are losing jobs and finding COBRA coverage too costly. These are the people struggling to keep their homes, feed their family and pay the rising utility bills.
There are affordable Individual Health Insurance Plans and Family Health Insurance Plans available for those without preexisting conditions. There are also Short Term Health Insurance Plans available for those who need temporary health insurance coverage until other policies are available in the work place or private sector. Short-term health insurance plans are designed to protect against unforeseen accidents or illnesses, rather than to provide comprehensive coverage. Short term health insurance plans do not include coverage for preventive care, physicals, immunizations, dental or vision care. Short term health insurance plans do not cover preexisting medical conditions. A last resort, low cost medical discount plans are also in the market place. Whatever you choose, it is important for you to read the plans carefully and asks questions about any part you do not understand.
Please review the National Healthcare Bill, ask questions to ascertain the answers regarding preexisting conditions. Everyone needs to know exactly what it means, when the exclusions go into effect and how they will impact you and your family.
Since 1975, we have been offering insurance product options to individuals and families to help offset the high cost of medical care.
