Pre-Existing Conditions, HIPAA and Health Insurance

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Pre-existing conditions

People who don’t have health insurance coverage have a terrible problem meeting the rising costs of health care. Unfortunately, those with pre-existing conditions have even greater trouble. They are more likely to require health care and so tend to have to pay more annually than other people without insurance.

A pre-existing condition is anything you have been treated for in the past. Pre-existing conditions include:

  • Cancer
  • Diabetes
  • Heart disease
  • High blood pressure
  • Asthma
  • Obesity

Different insurance providers have different criteria about what does and does not count as a pre-existing condition. Some insurers offer comprehensive coverage after a set period of time, often two years. Many insurers will flat-out refuse to issue a policy.

Pre-existing condition insurance is our specialty

We offer various plans from nine different insurers in all 50 states to cater to your specific needs.

We understand how traumatic it can be searching (and being rejected) for a policy to cover diabetes, cancer and heart troubles while you are suffering from the conditions themselves. First-rate pre-existing health insurance does exist, and now you know where to find it.

Who provides health insurance for pre-existing conditions?

In the US there are nine insurance providers that sell policies for pre-existing conditions, including AETNA, Blue Cross, Blue Shield and Cinergy Health. State regulation of the health insurance industry varies which means that not all policies are available in all states. We have a relationship with all of the carriers and are informed anytime policies change or new plans are launched.

Conventional insurers tend not to provide health insurance for those with pre-existing conditions because they are too high-risk. People with preexisting conditions are more likely to claim more often and conventional insurers would rather not have them on their books.

Traditional insurers could raise the premiums to account for the extra risk but this would only mean the policies would be prohibitively expensive for most people.

More recently, limited benefit health insurance plans have become available from insurers who are generally A-rated and are willing to accept people that traditional insures reject.

HIPAA and pre-existing conditions

The Health Insurance Portability and Accountability Act of 1996, more commonly known as HIPAA, left it up to insurers to decide whether they wanted to cover people with pre-existing conditions or not.

The act means insurers can exclude people even if they have previously been covered if that cover is not deemed creditable. Creditable cover can be from any of the following sources as long as the person has been enrolled in the plan sometime in the past 63 days:

  • Association health plans
  • Federal or state employee benefits
  • Group health insurance
  • Health maintenance organizations
  • Individual health plans
  • Medicaid
  • Medicare
  • Public health plans (from a state or foreign country)
  • State high-risk pools
  • The Indian Health Service
  • Veterans’ benefits or other cover for the uniformed services

Even when applicants are accepted for health insurance they often have to wait-out an exclusion period, often of one to two years, after they enroll.

It all depends on when you were last treated for your pre-existing condition and the particular time limits the insurer sets.


Millions of people in America are in the same boat – looking for insurance that will cover their preexisting condition. The problem becomes exacerbated when they have been rejected so many times or unable to find sufficient cover that they get caught by an insurance scam.

Beware of unregulated insurers

Non-HIPAA compliant health insurance does not offer complete insurance cover and is to be avoided. Often these plans are not backed by a regulated insurer and so may not even pay out. The worst part is when people think they have insurance and then, when they really need it, realize they don’t.

Fraudulent health insurance plans will take your money and provide little or no benefit in return. You can check with your state’s Office of Insurance Regulation, Department of Financial Services or the Better Business Bureau to see if the provider you are considering is legitimate.

Our policies

We offer a number of polices for those suffering with pre-existing conditions. You are guaranteed acceptance for these policies whatever your pre-existing condition.

We specialize in guaranteed issue health insurance for pre-existing conditions for those who have had difficulties getting insurance elsewhere.

The main point is everyone is accepted. If you have found it hard to get insurance in the past, try us. All of our policies give you access to Preferred Provider Organization network re-pricing to help cut the costs of your medical bills.

We have the policies you need. Fill out the form and get a quote from a licensed agent today.

Use technology to reduce your medical bills

If you are still worried about rising health care costs, consider how technology can help. Many doctors are willing to communicate by telephone and email and charge significantly less than for a face-to-face meeting. While not always appropriate, you can definitely save money by cutting down your number of visits to the doctor and replacing them with other forms of contact.

Similarly, the internet is a valuable to tool to perform your own research on the treatment and prevention of many diseases. While not to be relied on completely, many sites offer an excellent level of information completely for free.

Certain medical services are particularly suited to digitization using modern technology. Many visits to the doctor can now be avoided such as refilling prescriptions and getting opinions after tests. Fill out the form to speak to an insurance agent who can tell you how your phone or computer can save you money on your medical bills.

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