Pre-existing condition rejection

 

There’s been all this talk lately about pre-existing conditions. Before the American Care Act (ACA, aka Obamacare) and the protections it put in place, insurance companies charged more and often denied people for “pre-existing conditions,” a term the companies themselves coined.

These conditions have never been legally defined, but were identified by insurance companies in an effort to discourage going without insurance for long periods, only to purchase it when you fall seriously ill. This type of illness-only purchasing could drive costs up for all covered.

Without a regulated system to determine if a patient was “last-minute” purchasing insurance once they were sick, these elevated fees and routine denials were handed out for years to patients with pre-existing conditions. Children born with diabetes couldn’t get coverage, and patients with mental health diagnoses were disqualified even from basic coverage, or only accepted at exorbitant rates.

The ACA recently established protections for people with pre-existing conditions. But now that the structure of healthcare in America might be changing, the term has come back up.

Pre-existing conditions, however, remain undefined by any legal rubric. They are defined by whatever the insurance companies say makes you “high-risk.”

Are you of the 1 in 2 in Georgia who could have a pre-existing condition?

In Georgia, 49-51% of non-elderly in every Congressional district could be ineligible due to their pre-existing conditions, according to AmericanProgress.org research. Between 45 and 54 years of age, that jumps to 74%, and up in every age bracket thereafter.

If you have any of the following, or even a history of one, make sure you know your options to get healthcare, no matter what happens in Congress.

• Anxiety
• Arteritis
• Asthma
• Depression
• Diabetes
• Menstrual irregularities
• Obesity
• If you are or may become pregnant

So, what can you do? Even pre- and post-natal care will potentially disqualify a patient, or at least limit her to coverage that’s impossibly out of budget.

Direct Primary Care is the only model that doesn’t use insurance at all.

Our vision is to give you the best care, and with the most facetime with your doctor. And we don’t qualify or disqualify patients based on pre-existing conditions, ever.

With a small monthly fee per patient, our practice doesn’t have the overhead that clinics bound to insurance companies do. And with that room to breathe, we develop a relationship with you without the pressures of double-booking or offering only what your insurance covers.

We will keep you up-to-date. Your health is always on our mind.

With new legislation getting de- and re-constructed in Congress, we want to keep you informed. The numbers we’ve seen of patients in Georgia whose coverage is now precarious are staggering, and we are taking these issues very personally. With the hope of keeping everyone informed, we will be posting regular updates about the current state of healthcare in our Daily Dose.

Be sure to contact us with any comments or questions. Or, if there’s something you want to learn more about, let us know! We’ll write up an article so that everyone can see the question answered!

 

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