Posted by Guy Girardin

The Affordable Care Act is complex to understand so there are many misconceptions about it that can lead people to make decisions based on inaccurate and incomplete information or simply because it is misunderstood. One such misconception revolves around the topic of "pre-existing" conditions. Understanding this subject may save you thousands of dollars in health care expense. 

With the exception of some grandfathered plans, under the Affordable Care Act health insurance companies can't refuse to cover you or charge you more just because you have a "pre-existing condition" — that is, a health problem you had before the date that new health coverage starts. Prior to this regulation being enacted, healthy people were compelled to carry health insurance "just in case" which is potentially more expensive than necessary. Bizarre as it may seem, eliminating the exclusions for pre-existing conditions makes acquiring insurance after a condition has developed a viable strategy. 

For most people, a few trips a year to the doctor is pretty standard, with maybe an occasional visit to emergency. Minimum Essential Coverage (MEC) plans such as those offered by TEN99 provide exactly that level of care on a "first-dollar" basis without deductibles, co-payments or co-insurance. They won't help you in the event of a major or catastrophic event such as an accident or being diagnosed with a serious illness. So what good are they?

Because you cannot be denied coverage for a pre-existing condition, under the Affordable Care Act, you and your family can sign up for major medical insurance on the exchanges outside of the open enrollment period if you experience certain qualifying life events. Such qualifying life events include marriage, childbirth, loss of income and other major changes. In most cases, you have 60 days after the date that triggered the qualifying life event to purchase major medical health insurance coverage.

Should a catastrophic event such as an accident or serious illness take place, it's likely that a loss of income will follow, hence generating a qualifying life event and thus the opportunity to enroll in more robust coverage on the exchanges that will provide the level of care that circumstances now deem necessary. It is also possible to purchase Critical Illness, Accident and Hospital Confinement Indemnity insurances that pay cash benefits to help in the transition between plans.

Of course the newer, more robust coverage will most likely be significantly more expensive, but in the interim you will potentially have saved thousands, perhaps tens of thousands of dollars.

This is not a strategy for everyone, but one you might consider if you're healthy and your primary motivation for purchasing healthcare coverage is to avoid the IRS penalties.


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