Posts Tagged - ‘pre-existing conditions’

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Those buying family health insurance will see a significant benefit in healthcare reform within a year. What is it?

This particular change is very important: health insurance companies will no longer be allowed to deny families coverage due to a child’s health status. Sometimes, children are born with pre-existing conditions. Clearly, it is through no fault of their own. In the past, companies were able to refuse to sell a health insurance plan to a family whose child had a potentially expensive condition.

The provision will be especially helpful to the self-employed or parents whose firms don’t offer health benefits.

(Image: szlea under CC 3.0)

This is a big error in the healthcare reform bill: now, some health insurance companies are saying that they do not have to cover kids with pre-existing conditions!

That was supposed to be one of the main immediate benefits of the bill. Unfortunately, insurers believe that the language only requires them to cover pre-existing conditions for children already under a family health insurance policy. They still reserve the right to refuse to offer them a health insurance plan altogether, until 2014 (when the guidelines for adults take effect). Basically, their lawyers take the language to mean that if they extend coverage to a child under the age of 19, that coverage must encompass all of their health issues, pre-existing or otherwise; however, they can still deny the child coverage.

While still an improvement, it is a severe disappointment. The Obama administration is currently crafting an executive order with regulations that will clarify the issue, while Congress is working to resolve it.