It is open enrollment for my company. Do I still have to worry about qualifying for coverage because I have a pre-existing condition?
Concerned with a Condition
As of January 1, 2014, the Affordable Care Act (ACA) prevents health insurance companies from denying anyone coverage due to a pre-existing condition* under new health insurance policies. What this means is that, as people’s health insurance plans renew throughout this year, or as people switch plans or obtain new policies, that policy cannot include a “pre-existing condition statement” to prevent coverage of any existing medical condition, provided the policy went into effect on or after January 1, 2014. So once you re-enroll or enroll in a new plan offered by your employer this year, your pre-existing condition cannot prevent you from receiving coverage for that condition.
The law’s preclusion of pre-existing conditions does not apply to all policies. Plans that are grandfathered are not required to include the same consumer protections as new plans. To figure out if you have a grandfathered plan, review this information and contact your employer or your health plan’s benefits administrator.
* A pre-existing condition is any medical condition you have prior to enrolling in a health insurance plan.
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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.
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