What happens when people undergoing treatment for chronic conditions such as depression, high blood pressure, diabetes, or cancer lose or worse, cannot get health coverage because of their “pre-existing condition”? A pre-existing condition is a health condition or illness that you have had before your first day of coverage on a new plan. So how does a condition like this affect your health care coverage? Well first, pre-existing conditions can cost an insurance company millions! Many health insurance companies exclude those who have them. Some conditions may not affect your health coverage but some can keep you from having coverage for up to a year.

Karen Pollitz, the project director at the Health Policy Institute at Georgetown University, gave Health.com some answers to questions on how to stay covered when you have a pre-existing condition.

• What’s the best way to maintain healthcare coverage if you have a chronic condition? 
    o  First, Pollitz recommends that you see if there is any way you can qualify for job-based coverage. This includes a job that you may be in that offers benefits you aren’t aware of and haven’t signed up for, or a spouse may have a job that has benefits for your condition. The reason this is so important is because “under the Health Insurance Portability and Accountability Act (HIPAA), if the coverage is offered, the employer can’t say, "I’m not going to let you into my health plan because you have breast cancer"—or any other health issue. They must offer you the same benefits and they must kick in the same percentage of premium as they would for anyone else.”

•  So this chronic health condition will not be a problem if you have coverage through an employer? 
    o Under the HIPPA, an employer cannot discriminate against you, but the health plan can still deny coverage of pre-existing conditions for new employees for a period of 6 to 12 months.
 
• What if you leave your job, how do you keep your coverage? 
    o Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), if your employer has at least 20 employees and sponsors a health plan, you will probably be eligible to receive continued coverage under that plan for up to 18 months. Under COBRA, your employer is not longer required to contribute anything towards your premium so you have to pay 100% of it. You may also have to pay a 2% administrative fee.

• So what happens when your COBRA runs out after 18 months? 
    o Then your options start to get a little tricky, explains Pollitz. This is when you become “HIPPA-eligible,” which means you must meet all of the following criteria.
         -You must have had the 18 months of continuous creditable coverage
         -You must have used up any COBRA for which you were eligible
         -You must not be eligible for Medicare, Medicaid, or a group health plan
         -You must not have health insurance
         -And you must apply for health insurance for which you are federally eligible 
          within 63 days of losing your prior coverage.
    o HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. HIPAA established special protections people when they lose group health coverage. Once people become HIPAA-eligible, they are guaranteed an offer of at least two health insurance policies that do not impose pre-existing condition exclusion periods. In some states, HIPAA rules apply to all private insurance companies that sell coverage in the individual health insurance market. Some states, however, have made alternative arrangements to guarantee these HIPAA protections only from the state high-risk pool. Private insurers in these states are still free to medically underwrite their policies and deny applicants and impose pre-ex periods, even for HIPAA eligible individuals (American Diabetes Association).

Staying insured is very important, no matter what conditions you may have. These are just a few ways to stay insured when you have pre-existing conditions among others.