The health care reform mandates are expected to eventually prevent health insurance companies from denying coverage to people based on their preexisting conditions or medical histories. However, not all of those mandates are in place as of now.
Many people have been hoping and planning for the day when their medical history wouldn’t be held against them when wanted to be covered by a health insurance plan. Many people, including myself, believe that one’s need for medical services should not mean that they lose the roof over their head and the food on their table.
After many news reports and article after article full of information about the passing of the health care reform act many people believe that that day and time came months ago. It hasn’t. At least not yet.
The mandates are being phased in over time. Right now, at least for the most part, the old rules are in place for adults. The way children are underwritten has changed. Therefore how and if they can get medical treatment from doctors and other providers covered has changed as well. No significant changes have been made in the way adults are underwritten thus far.
Qualifying for group health insurance coverage of doctor and hospital costs in Connecticut is not based on your medical history. (The rules are different for individual non group policies or polices not purchased through our work.) You can even purchase a “one person group” health insurance policy from a health insurance company if you are self-employed and have no employees. This is the same as it was before.
Children cannot be denied coverage based on their medical condition. They must, however, be on a policy that includes at least one parent. If neither parent qualifies for a health insurance the child will also be denied.
This applies to policies purchased after the September 2010 mandates. If your child was covered by a policy child-only health plan prior to the September 23rd of 2010 you should continue to pay its premium as it can be kept active. (This is an unintended, unfortunate result of some of the September health care reform mandates. For more information, please view my video about how health care reform is hurting children.)
If you need health insurance for a child in Connecticut but not for the child’s parents, the HUSKY program may be your best option. HUSKY is a state-sponsored health insurance program that works well for many families. You will find, however that their list of providers is more limited than the list associated with a health policy one might get from a company like Blue Cross Blue Shield. Husky is available to all income levels, but the amount you pay each month is based on your family’s income.
A Health insurance company can deny an adult who applies for and individual or family health policy that is not employer-sponsored. They can deny based on an applicant’s preexisting condition or conditions. They can charge more or less based on an adult’ health history. (Some companies can double the premiums for those who need a doctor’s care for a medical condition. This means making the monthly payment is very difficult or impossible for many Connecticut residents.) They can exclude coverage for treatment involving specific body parts or medical conditions. In short, nothing has changed so far and it will be some time before things do.
Unless the health care reform law is repealed or amended one’s medical history will not prevent them from qualifying for health insurance as of the year 2014. This will be a great day for many who would otherwise risk losing their homes and life savings because of the cost of few months’ worth of medical treatments.
(It is important to note that not all medical conditions will result in a denial or even a modification of a health insurance policy. For more information you can read my post regarding how to find coverage for preexisting conditions in Connecticut.
For advice regarding your specific medical condition please call and speak with me, Alston Balkcom or my son Joel Balkcom. You can reach us at late as 9 pm at 1-203-374-3645 or 1 800 insurance.