If the insurance companies had their way yeah, pretty much anything would qualify as a pre-existing condition. Many states have passed legislation defining what can and can’t fall un pre-existing condition exclusions (one from California has already been mentioned).
Yes. And have.
No. Why would there be? The insurance company is not your friend and doesn’t care how the condition came about.
If they are serious enough to have required consultation with a doctor then they’re a pre-existing medical condition ever afterward.
Sure. Any surgery and it’s possible consequences would be a pre-existing condition.
Potentially, yes. That was certainly the way it used to work.
Welcome to reality in America.
The insurance company doesn’t give a flying fuck if your kid’s college fund is drained, or your retirement savings raided, you lose your house, and you and yours are bankrupt. The insurance company does not care. They don’t care if you wind up sick and in a homeless shelter.
As I said - welcome to reality in the US.
You forgot “death of a family member” - when my husband died I lost my health insurance because it fell under a type of Medicaid and with just one person in the household my income was too high to qualify. So yeah, my husband died and then I lost my health insurance. That sucked.
Fortunately (?!?!) death of a spouse is a QLE - I was able to get onto my employer’s insurance.
But let’s be clear, the fundamental problem with “reality in America” is not that private insurance companies are full of mean people and are not operating like charities. They are supposed to be businesses run for profit.
The problem lies 100% with incompetent US government healthcare policy.
A government can either (a) make health insurance obligatory for everyone, regardless of state of health, so that the funding pool is adequate (this is what every other developed country in the world does, one way or another). Or the government can (b) leave it up to individuals to find healthcare where they can, if and when they choose to. Under the latter approach, they must allow private for-profit insurance companies to use the same information that the buyer of the policy is privy to when assessing the expected liability from issuing an insurance policy, otherwise insurance is simply not a viable business. The fact that this fucks over anyone with a preexisting condition is the reason that every other developed country in the world chooses option (a) as a matter of government policy.
It’s not all that fair if you look at this as a problem to be solved with insurance. But do people want health insurance? It seems like what they want is care, not insurance. On basically every question, if you ask people how they want the system to work, they want it to look less like insurance and more like a universal benefit.
Exactly. The language of insurance screws up the discussion. UHC is a government benefit, just like police, fire, roads and schools. I don’t talk about my “police insurance” or my “firefighters insurance” or my kid’s “education insurance”. They’re all benefits provided by the government, funded out of tax revenue. Universal health care is just another government program.
In our system (Canada), “pre-existing conditions” are irrelevant (except as needed by the doctor to understand the patient’s medical history). Although there are vestigial uses of the language of insurance, in practice medicare is another government benefit.
In the U.K., nobody would have a clue what “pre-existing condition” even means as a phrase. Likewise (in the context of healthcare) “in-network”, “co-pay”, “deductible”, “pre-approval”.
When you come from a country with a fairly sensibly-run universal healthcare system, it takes a long time to learn all the terminology used in the U.S., because it involves learning the screwy internal logic of a completely dysfunctional system.
When we sign up new patients here (in Norway, private side) we have a section on the form for people to enter pre-existing conditions. Its so that we can be aware of them. Previous exposure to asbestos, drug allergies, diabetes, etc, etc… stuff we need to know about.
We’ve not had an American fill in those forms so far, but anecdotally I hear from colleagues that the section can cause anything from a deer-in-the-headlights look to mild panic in Americans.
I don’t understand the confusion. ANYTHING can be “pre-existing.”
All that “pre-existing” means, is that you had whatever it is before you tried to get “insurance” to pay for it.
Having your car stolen can be a pre-existing condition. You can’t go to an auto-insurance company and get insurance on a car that’s already been stolen, and then get them to pay you for that.
Simple way to think of it: look down the list of whatever the insurance company says they are willing to pay for. EVERYTHING ON THAT LIST WOULD BE CONSIDERED A PRE-EXISTING CONDITION IF YOU HAD IT AT THE TIME YOU SIGNED UP.
Now. Most providers wont police the system strenuously for small things, but if you do put in for payments too quickly after signing up with many of them, you will have trouble getting paid.
To be clear, under most policies right now (those that are ACA-compliant), you will not have a problem with this, because pre-existing conditions are covered. The importance of the question lies in what may happen if this administration eventually passes a healthcare bill.
It can also lead to lying in Americans desperate to hide a pre-existing condition for fear of being refused treatment. Which is no way to run a healthcare system, and could lead to serious omissions in filling forms such as what you folks use.
The problem with this comparison is that it isn’t insurance and never has been. Going to the doctor is a certainty, not a “risk”. And yet most “insurance” covers it to some degree.
The United States has always had “subsidized healthcare”, not insurance, ever since the first factories started offering it during the war to compensate workers under wage controls. The whole point was that “we’ll pay you in healthcare because we can’t pay you more in cash”. It was never about “pooling risk” or “'mitigating a catastrophe” or whatever insurance is actually used for. Going to the doctor, or the hospital, or having medical issues that need treatment aren’t unforeseen costs requiring risk management, they’re dead certainties that employers pay for as a benefit to their employees.
The only question now is whether that subsidized healthcare will remain a treat for those who are employed in a particularly generous field of work, or whether we will extend that subsidy to all Americans.
I posted the following to Facebook a few days ago. It’s from time.com/money – I can look up the exact cite if anyone wants:
I have arthritis and sleep apnea. I have a history of kidney stones and asthma. I am 63 years old, and I suspect that just about everyone my age has a condition that’s on or the other of the above lists.
The way pre-existing condition exclusions worked prior to the ACA is that they could refuse to cover you for any of that for the first 18 (IIRC) months of your health insurance coverage. But after that, they could not. So as long as you held onto insurance for those 40 years (or had minimum lapses with less than 63 days without coverage), then you’d be covered. But people just getting insurance after having a long period without would have to be potentially subject to pre-existing condition exclusions for things from decades earlier - at least for 18 months or so.
When I first signed up for individual insurance there was a lag time between when you signed up and when you could use the insurance . That was to make sure I was not signing up to treat a pre-existing condition. Pre-existing conditions can not be insured against so insurance is not the right way to handle it. Before it all got so complicated older people who wanted health insurance could take a physical to have their level of risk assessed.
Actually, I know a whole lot of people who had pre-existing conditions which the insurance companies considered too high-risk to write policies for at all. Diabetics, people with heart disease, people who had childhood cancers, etc. My daughter was unable to find an insurance company that would even give her a quote for a catastrophic coverage policy. My daughter had a classmate who had an unexplained illness at age 5, never had a recurrence, and couldn’t find health insurance, either.
This was in Missouri. Different states had different rules, YMMV.
Well, yes, there was no requirement that insurance covered anyone. But that isn’t the same thing as pre-existing condition exclusions.
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That is too far. I wonder how much this goes on CONUS. I sold insurance once upon a time and since we collected saliva for certain policies (150+ I believe) it is not impossible that genetic scrutiny was conducted under the guise of drug and critical illness testing
