Condition Insurance Policies

by | Sep 8, 2013 | Individual Health, Insurance

Health Insurance mandates in the U.S. have changed due to the “Patient Protection and Affordability Act” passed on March 23rd of 2010. This new law has a number of positive changes for the uninsured, insured, and Medicare recipients. For the uninsured, the government has initiated a Pre-existing Condition Insurance Policy for those that cannot receive insurance due to a previous illness. These policies are issued to persons who have not had insurance in the past six months and who are uninsurable. An uninsurable person would be one that has been turned down to purchase major medical coverage after being diagnosed with a condition such as cancer, heart or liver disease, diabetes, bi-polar illness, HIV, stroke, etc. Usually, conditions such as high blood pressure, high cholesterol, smoking and abnormal weight gain, excluding obesity, are rated conditions and are accepted by the major medical companies at an additional cost or waiver to the consumer.
For some uninsurable persons, the government’s PCIP is not affordable and they do not qualify for Medicare or Medicaid. For those persons, we have “Limited Benefit Plans” that are guarantee issue and will give much of the needed care to reduce catastrophic expenses when confronted with an illness. These policies participate in major PPO networks and many offer doctor’s office visits for a set fee of $50 or less; provide scheduled dollar allowances for medical expenses in such areas as diagnostic care, hospital confinements, surgeons’ and anesthesiologists’ benefits. Usually, with some exceptions to generic drugs, brand named pharmaceuticals are provided at the PPO network’s pre-negotiated rates.