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Health insurance companies, after reviewing the application of someone with a pre-existing condition reserve the right to:

  • increase the rate
  • eliminate coverage for certain conditions
  • refuse to offer coverage

The medical insurance company’s decision can be appealed, but usually the appeal fails. The most important thing to remember about pre-existing conditions is that every company looks at them differently. I’ve had clients who were denied by Aetna who were approved by Anthem Blue Cross and vice versa. If you had a heart attack last year, are currently being treated for cancer or take insulin for diabetes, you will probably be denied every plan that medically underwrites their policies. If you have asthma, high blood pressure, or one of many other conditions that are less significant, you may be denied by company A and approved by company B. Talk with your broker before giving up if you have received an answer you don’t like.

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