Health Insurance For Pre Existing Conditions – This article is about: How insurance defines a pre-existing condition The two different types of health insurance in Canada How health insurance works for pre-existing conditions Why health insurance doesn’t provide coverage Bonus: We also talk about a good alternative to health insurance, which is ( *Note *) offers comprehensive insurance cover, even if you have previous illnesses. What is a pre-existing condition? In health insurance, a pre-existing condition is any medical or health condition that exists or has already been diagnosed at the time of the insurance application. A pre-existing condition also exists if symptoms occurred for which a reasonable person should or should have sought medical advice or treatment. What is health insurance and does it cover pre-existing conditions? There are two types of health insurance: public and private. In Canada, public health insurance is provided by provincial governments under the Canada Health Act. It covers all pre-existing conditions. Health services are provided by the province in which the person resides. Examples of public health services provided include: treatment, diagnosis and health testing by a doctor. Treatments in a hospital emergency room. Hospital stays. Any other health care services provided by a physician or surgeon. These health services are paid for by the Province with no direct cost to the user accessing the service and no exclusion for pre-existing pathologies. Prescription drug therapy administered in the hospital is also paid for by the provincial government. Most provinces plan to pay for ongoing prescription drug therapy outside of hospitalization. Many provincial health insurance plans include some type of coverage for prescription drugs, including those used to treat pre-existing conditions. Individual private health insurance policies are marketed and sold by insurance companies. These plans select pre-existing conditions at the time of application and exclude pre-existing conditions or deny coverage entirely. Examples of private health insurance include: Ambulance, Private or semi-private hospital, Prescription drugs, Paramedical practitioners – such as chiropractic, massage, physiotherapy, etc., Dentistry, Eye care, Private health insurance is expensive in relation to the services provided. In most cases, it is best for a person to pay for non-catastrophic* services as they arise. Instead of paying a premium, set aside money each month to pay for health and dental care. Check with your state health insurance provider to see what prescription drug, private or semi-private hospital, and ambulance insurance benefits are available. Each year when you file your personal tax return, check to see if you are eligible for medical tax relief. If you are a registered small business owner, you should consider setting up an HSA (health care spending account) to convert all of your pre-tax health and dental bills into pre-tax business expenses. I am a small business owner. How do I get health and dental insurance if I have a pre-existing condition? Many Canadians seeking health and dental insurance may have pre-existing conditions. Depending on your condition, this may limit your options. However, there is an alternative to private health insurance. A health spending account (HSA) offers the same basic solution and is available to people with pre-existing conditions. An HSA incorporates tax planning principles coupled with health insurance and is designed specifically for small business owners. Why doesn’t private health insurance cover pre-existing conditions? Before we get into how an HSA works. Let’s explore why traditional health insurance doesn’t cover people with pre-existing conditions. Simply put, they know they will incur higher costs, which in turn reduces their profits. After all, insurance companies work by calculating numbers. Some insurance plans may still provide coverage, but the premiums will undoubtedly be higher than a plan with no pre-existing conditions. In addition, you are subject to complicated terms and conditions. This brings us to the second point. Should I avoid private health insurance? As noted above, health and dental expenses are classified as non-catastrophic/planned events. For example, you go to the dentist 1-2 times a year to have your teeth cleaned. This is a scheduled event because you scheduled it on your calendar. On the other hand, there are random (or unplanned) events. These are usually catastrophic events with a low probability of occurrence. An example would be a house fire or a fatal car accident. The probability of occurrence is low, but the event is still plausible. There is insurance for these random events. You pay the insurer a premium for transferring your individual risk. The bottom line is: You don’t need to insure health and dental expenses because they are planned/administrative/maintenance events. It is wiser to invest in an HSA to avoid taxes on these expenses. Note: Unforeseen health and dental events such as tooth decay may occur but are not insurable. To add to this point, a cavity is unplanned but also not catastrophic, meaning the cost is not high enough to require insurance. Can you explain more about how a health spending account works and why it covers pre-existing conditions? An HSA allows a small business to deduct 100% of its health and dental expenses without paying the standard premiums typically associated with private health insurance. The traditional way of paying a recurring premium and getting coverage doesn’t work. It covers principles of both tax planning and health insurance. To qualify for this plan, you must own or operate a registered small business. To sum up an HSA in one sentence: It legally wipes out your personal health expenses. In other words, it turns your after-tax personal medical expenses into a pre-tax business expense. In most cases, this method will save you more money than paying a monthly premium for private health insurance coverage. More importantly, an HSA does not discriminate against those with pre-existing conditions. You can request reimbursement for all health care costs, including those incurred before signing an HSA plan. Do you own a registered business with no independent employees? Learn more about a Health Spending Account (HSA) by downloading our FREE guide below: If you own a business with independent employees, check out this guide instead or click below: Further Reading on Health Insurance vs. HSA: 5 Reasons Why A health spending account makes sense. Better than health insurance. How exactly does a health spending account save my business money?! Health insurance for a family business doesn’t have to be complicated
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Health Insurance For Pre Existing Conditions
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What are pre-existing conditions and who has them? In the simplest terms, a pre-existing condition is any health condition that a person had before enrolling in health insurance. The person may know about a pre-existing condition, for example if they know they are already pregnant. People may also seek coverage if they unknowingly have an undiagnosed condition – for example, cancer cells may be growing inside but are not diagnosed until months or years later. A pre-existing condition may be mild, such as a seasonal allergy or acne, which is treated with simple medications. Or it could be more serious or require more expensive treatment, such as diabetes, heart disease or cancer.
In 2018, it was estimated that approximately 54 million non-elderly adults in the United States (27%) had “deductible” pre-existing conditions that would have made them “uninsurable” in the pre-ACA individual health insurance market. Rejecting terms were identified through an analysis of health insurers’ underwriting manuals. Insurers maintained lists of health conditions for which applicants were routinely denied coverage. Rejecting medical conditions included AIDS/HIV, heart failure, diabetes, epilepsy, severe obesity, pregnancy, and severe mental disorders. Of course, not all of these 54 million adults currently purchase individual health insurance. But the individual market is where people turn when they find themselves in between jobs that offer health benefits and don’t qualify for coverage through public plans like Medicare or Medicaid. If he would go back to health insurance
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