Monday, February 21, 2011

Pre-Existing Conditions Plan: Stupidly Restrictive

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I've been reading up on the Pre-Existing Condition Insurance Plan provided for under the health care reform legislation passed by Congress in 2010. In theory it's an important and great idea: to provide a safety net that allows people who have been rejected by insurance carriers due to pre-existing health conditions to buy insurance at rates comparable to those paid by healthy people. Unfortunately there are some really stupid, restrictive rules.

To be eligible to apply you must have been without health insurance coverage for six months. This is similar to the gap built in to Medicare as it applies to disabled people that requires them to wait two years after being approved for Social Security Disability benefits before they become eligible for Medicare. Because when you are so sick you're unable to hold a job it's so common to have health insurance from some other source.

These delays lead to catastrophic consequences for people's health and financial stability. If you have a pre-existing condition you most likely need treatment for that condition. After all, that's why insurance companies have refused to cover you: you'll be too expensive. So now a program that's supposed to fill the gap while we wait for the law prohibiting insurance companies from discriminating on the basis of pre-existing conditions to take effect leaves yet another gap for people who already have compromised health. Six months for your diabetes, heart disease or arthritis to go largely untreated. This not only harms the individual, it drives up the cost of health care for everyone by leaving treatable conditions undertreated, creating a need for more expensive interventions down the line. It's frustrating and mind boggling.

Pre-Existing Condition Insurance Plan: Questions & Answers

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DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.