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Pre-existing conditions and health insurances

On Behalf of | May 20, 2020 | Uncategorized

There are countless people who count with a pre-existing health condition before they start work at a new place. One of the many misconceptions that exist is that, if they already had this condition before the new job, then they do not qualify for health insurance in their new job. This is not true, and several employees have fallen into this trap believing this myth. It is important to know how pre-existing conditions work and how it can affect an employee’s health insurance.

Objective standard vs. prudent person

This occurs when a person has a health condition that originated due to an injury or illness. The person already had this condition before starting a new position in a new job and before he or she enrolled with an insurance provider. Usually, insurance companies have two standards to analyze a pre-existing condition. First, they follow the objective standard, which is when the employee has a medical condition prior to him or her enrolling in the new insurance plan. The second is called the prudent person, which is when the employee would have seen or felt some of the symptoms before enrolling in the new position and a prudent person would have sought treatment.

Can health insurance be denied?

Not for having a pre-existing condition. No health plan can deny coverage or raise rates for plans if the employee already has a serious condition that arose with an illness or injury. However, the employee must know that there are several other health plans that probably work better for his or her pre-existing condition than others. If the employee will need surgery, then maybe choosing a plan with higher premium and a lower deductible may be the better choice.