People undergoing treatment for chronic conditions—like depression, diabetes, high blood pressure, or cancer—need to be careful to avoid triggering what’s known as a "preexisting condition" exclusion. Once you trigger this clause, most carriers will try to deny paying any claims for that condition for a period of time. Karen Pollitz, project director at the Health Policy Institute at Georgetown University, explains how to keep yourself covered.
What’s the best way to maintain my health-care coverage if I have a chronic condition?
The first thing I recommend is to see if there is any way you can qualify for job-based coverage. Are you in a job that offers benefits that you hadn’t signed up for, or do you have a spouse with a job that has benefits?
The reason is that you have the most legal protection in job-based health plans. Under the Health Insurance Portability and Accountability Act (HIPAA), if the coverage is offered, the employer can’t say, "I’m not going to let you into my health plan because you have breast cancer"—or any other health issue. They must offer you the same benefits and they must kick in the same percentage of premium as they would for anyone else.
Bottom line: Job-based health plans also tend to be the most affordable, because employers pay, on average, about 75% to 85% of the premium for you.
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