Have Pre-existing Condition? What Could This Mean for You.

It Appears Trump wants “guaranteed issue” to disappear and when you have a pre-existing illness.

Under the Affordable Care Act (ACA), also called Obamacare, you cannot be denied insurance coverage because you have pre-existing conditions, disease, or illness. This is called “guaranteed issue,” which means that a “health plan must permit you to enroll regardless of health status, age, or gender.”

But what is I have a pre-existing condition or illness? Chances are you are saying “that won’t affect me – I’m healthy.” Don’t be so sure.

There are hundreds of illnesses that make up the list. Here are a few put together by the Kaiser Family Foundation.

·         ALS (Lou Gehrig’s Disease)

·         Alcohol/drug abuse

·         Alzheimer’s disease or other dementias

·         Chronic lung/pulmonary disorders (e.g. chronic bronchitis, COPD, cystic fibrosis)

·         Cirrhosis

·         Congestive heart failure

·         Diabetes (insulin-dependent)

·         Emphysema

·         End-Stage Renal Disease (ESRD)

·         Fibromyalgia

·         Heart disease

·         Hepatitis

·         Immune disorders (e.g. RA, MS, Lupus, AIDS)

·         Kidney disease requiring dialysis

·         Mental/nervous disorder

·         Myasthenia gravis

·         Organ transplant

·         Osteoporosis (if severe/disabling)

·         Stroke

·         Advised by a physician to have surgery, medical test, treatment, or therapy

·         Implantable cardiac defibrillator

·         Use of supplemental oxygen

·         Use of nebulizer

·         Asthma requiring continuous use of 3+ medications including inhalers

You can read more information about consumer protections in this link.

This list actually contains the illnesses that Medigap can use to deny coverage or charge more for coverage (see next blog for more on that.)

Another site, called Trumpcare, adds pregnancy, cancer, sleep apnea, obesity, high blood pressure, knee surgery, Parkinson’s, organ transplants, pacemakers, etc. etc. In other words, almost every disease known to man or woman.

Guaranteed Issue

The guaranteed issue prevents denial of coverage if you have a pre-existing condition but not necessarily a premium upcharge if you have any of these diseases and they accept you for their plan. For example, if you have diabetes, your premium would be increased by 137 percent. If you have a major depressive or bipolar disorder, you would pay 205 percent of the usual premium.

Kaiser estimates that 27 percent of the U.S. population has a condition that would qualify as a pre-existing disease. If legislation is passed killing Obamacare, Trumpcare may either deny you coverage or would, if you do get coverage, charge you a significant premium penalty.

Switch Plans with Caution

The upshot? Be careful when you switch plans. Find out all the pitfalls for not doing it on time. And pay attention to legislation that may be a thorn in millions of Americans’ sides.


Find The Best Supplemental Insurance Plans Today from Keith Armbrecht.

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