Does Health Insurance Cover Pre-Existing Conditions?

Does Health Insurance Cover Pre-Existing Conditions

Last Updated on July 17, 2023

If you are about to shop for health insurance anytime soon, you might wonder whether that covers pre-existing conditions. Maybe you are going to be covered under your employer’s health insurance plan, and you are wondering that same thing. This is a question that you need to have answered for you since this information can have serious financial repercussions.

We will discuss insurance coverage and whether it includes pre-existing conditions right now. There should never be any ambiguity about this issue.

How Does Healthcare Work in This Country?

First, let us briefly explain how health insurance works in America. This country has privatized health insurance. That means each person is responsible for getting their own health insurance, and the federal government and our tax dollars do not pay for it.

This situation is contrary to the healthcare system that exists in many other first-world countries. Since healthcare is privatized, your best methods of getting it are either purchasing a policy on your own through your state’s marketplace or else you can get it through an employer.

What Constitutes a Pre-Existing Condition?

As for pre-existing conditions, these are medical conditions that exist prior to you signing on with a healthcare plan. Regardless of whether you purchase a plan on your own or sign up for one as a benefit when you get a job with a company, you may have a medical condition that is either acute or chronic.

If these conditions existed before you signed up for your new healthcare plan, then they are thought of by the provider as being pre-existing. Something like chronic back pain, diabetes, or shingles that you had before signing up for your plan would all fall into this category.

The Change in Health Insurance Brought by the Affordable Care Act

The good news for consumers is that pre-existing conditions are indeed covered by your health insurance. There’s a provision in the Affordable Care Act, also sometimes called Obamacare, that stipulates that healthcare companies must let you sign up with them even if you have a pre-existing condition.

There’s no overemphasizing how much that matters. If you couldn’t sign up for a healthcare plan if you had a pre-existing condition, then you would probably have to pay for all the costs associated with your illness, injury, or condition on your own. You would have to pay for surgeries, medications, and medical devices out of your own pocket.

The healthcare providers fought that provision because they knew they would potentially lose money if they had to cover the bill for treatment for individuals with pre-existing conditions.

However, these companies still make millions of dollars every year, so they’re in no danger of becoming insolvent just because they have to pay for these kinds of treatments.

In short, while many individuals are dissatisfied with America’s current healthcare system, there’s a silver lining in the fact that pre-existing conditions are covered when you sign up for healthcare plans. This provision prevents millions of consumers from going bankrupt every year. 

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