An Ailment Could Delay or Rule Out Healthcare Coverage
The argument in favor of permitting exclusions based on pre-existing conditions is that without them, people wouldn't bother to buy insurance until they really needed it—for example, when they're being wheeled into the emergency room. "It's a penalty for waiting to get insurance," says Pollitz. "But a lot of people didn't wait. They had coverage, and they lost it."
Legislation introduced last month by Democratic Rep. Joe Courtney of Connecticut would shorten the period during which employers could withhold coverage for pre-existing conditions as well as the "look-back" period for which they could examine an employee's medical history. But health policy experts say the bill has little chance of passage, given the strong interest by insurers and employers in maintaining the status quo.
In the meantime, consumers who are concerned that they have pre-existing conditions should try to avoid gaps in coverage and, if they have a choice, think carefully before giving up their group coverage to buy an individual policy. But if you find yourself filling out an application for an individual policy, don't think for a minute that you can fudge an answer about your health and hope for the best. Covering up a pre-existing condition that way would give the insurer an opening to refuse to pay any claim you later file, but the company will be happy to accept your premium payments in the meantime. In this case, honesty really is the best policy.
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