A Quarter of US Adults Say They Have a Pre-Existing Condition

A Quarter of US Adults Say They Have a Pre-Existing Condition

A Quarter of US Adults Say They Have a Pre-Existing Condition. More than a third of people over 55 have a “pre-existing condition” according to a new Gallup Poll.

The poll highlights the risk of developing health conditions as you age. It also shows how your health might affect your ability to get health insurance – even on Medicare.

In some situations, insurance companies deny health coverage or charge higher rates to people with health problems. These “preexisting conditions” might include diseases like cancer or diabetes.

They can also include chronic ailments like high blood pressure, asthma, or even obesity. Individual insurance companies determine pre-existing conditions, there’s no universal guideline to conditions that cause problems with insurance applications.

A Quarter of US Adults Say They Have a Pre-Existing Condition

A Quarter of US Adults Say They Have a Pre-Existing Condition

A Quarter of US Adults Say They Have a Pre-Existing Condition

Gallup’s poll questions were for U.S. adults; it was asking whether they had a pre-existing condition and whether anyone in their household had a pre-existing condition.

In the poll, 27% had a preexisting condition; 16% were the only ones in their home with a condition, and 11% live with someone with a condition.

Another 17% said they didn’t have a pre-existing condition but a family member did. Altogether, this means that 44 percent of U.S. households include at least one person with a medical condition.

The numbers go up as people age:

  • 34 percent of people 50-64 years old said they had a pre-existing condition.
  • 38 percent of people 65 and older said they had a pre-existing condition.
  • In both age groups, slightly more than half reported that someone in their household had a pre-existing condition.

Aside from age, there are two factors coincide with preexisting conditions; being overweight and having an annual income of less than $30,000.

Pre-Existing Conditions and Insurance for People Under 65

Before the Affordable Care Act became law in 2010, insurance companies routinely denied coverage to people with preexisting conditions. The ACA is guaranteeing coverage at the same rate as other people your age, no matter what conditions you have.

The preexisting condition rule is a popular part of the ACA, but the law has been under attack. Some Republicans in Congress have vowed to repeal it. In December 2018, a federal judge in Texas ruled that the ACA was unconstitutional. However, the law remains in effect while the decision works its way through the appeals process.

This means a preexisting condition can’t prevent you from qualifying for insurance; however, there’s no guarantee the law won’t change in the future.

US Adults Have Pre-Existing Conditions and Medicare

Once you turn 65, you’re eligible for Medicare coverage. Medicare is available to younger people with Social Security Disability benefits. Medicare doesn’t look at health history; everyone who meets the basic qualifications can get coverage, and the premiums are standardized.

However, Medicare doesn’t pay all your medical expenses. For this reason, many people purchase a Medicare Supplement, or Medigap, plan. And preexisting conditions MAY BE a factor when you shop for Medigap coverage.

Here’s how it works:

Everyone has an open enrollment period for Medicare Supplement plans. It lasts for six months and begins as soon as you are both 65 and enrolled in Medicare Part B. Sign up for Medigap during this time and you won’t pay extra if you have a pre-existing condition.

If you sign up for Medigap after the Open Enrollment Period is over, the application goes through medical underwriting. This means the insurance company determines your premium with all your health expenses in mind. You may also have a waiting period before your preexisting conditions have coverage.

If you choose a Medicare Advantage plan, preexisting conditions aren’t an issue unless you have end-stage renal disease.

Taking good care of your health can prevent some preexisting conditions. If you have a health condition, pay attention to Medicare enrollment dates; this helps you to avoid being turned down or charged extra because of your health.

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