How to Get High Risk Health Insurance Even With a Pre-Existing Health Condition

Get Health Insurance Coverage No Matter What Your Current Health Status

M. Langton
When you have a severe or chronic health problem, the search for high risk health insurance that will help ease the burden of medical care can feel like a wild goose chase. Insurance companies pack so many exclusions into the fine print that just when you think you've found something, you discover you're not eligible. The good news, though, is that there are both private and state providers that can help you get coverage even when your health isn't the best.


Who Needs High Risk Health Insurance?

Health insurance companies are, after all, businesses interested in turning a profit. The more likely you are to make an insurance claim and cost them money, the less they want you. If you currently have a health condition that's likely to require aggressive or long-term treatment, chances are you'll be considered high risk for making a claim.

Some health problems that can push you into the high risk category include cancer, heart and cardiovascular diseases (eg. coronary heart disease, arrhythmia, and atherosclerosis), immunodeficiency conditions (eg. AIDS, Wiskott-Aldrich syndrome, and tuberculosis), and neurological conditions (eg. cerebral palsy, multiple sclerosis, Alzheimer's disease, and spinal cord injury). These include congenital conditions as well as diseases acquired later in life.

Where to Look for High Risk Health Insurance

If you currently have or have recently recovered from a health condition that would have placed in the high risk category, finding affordable insurance through private providers can be challenging, but doable.

When you have a serious or chronic health condition, it's vital to know your rights under federal and state law. State laws regarding coverage policies and premiums for individual health insurance vary widely, so it's worth taking a look at your state's regulations before you start your search.

If you believe the health condition you have isn't so serious as to preclude you from getting individual health insurance, contact your state insurance commissioner to find out how to learn more about your state's health insurance laws. For those aiming to get coverage through a large nationwide employer, the state commissioner may suggest contacting the Employee Benefits Security Administration of the United States Department of Labor.


State High Risk Health Insurance Pools

In the U.S., there are currently 33 states that offer state-sponsored health insurance for those who aren't able to get insurance through private companies. These programs are known as high risk pools or major risk pools. Eligibility requirements vary, but in general you'll need to prove that you're not eligible for other state-funded coverage such as Medicare and that you've been turned down for coverage by private providers. There's almost always a waiting list, which can range from three months to a year or more, and premiums also tend to be quite a bit higher than average.

Figuring out how to find high risk health insurance takes some time and dedicated research, but it is possible. Start by researching state and federal laws pertaining coverage available to those with your particular health condition and then look for a private health insurance company that can cover you. If you find you can't get coverage this way, check if your state offers a high risk health insurance pool.

Published by M. Langton

M. Langton holds a degree in East Central Europe Studies and works as a freelance writer covering travel, health, gardening and other topics.  View profile

  • Those with chronic conditions often need high risk health insurance.
  • State laws make it easier for those with health problems to get coverage.
  • High risk health insurance pools offer one last hope for the uninsurable.
An increasing number of states offer high risk health insurance pools. In 2008, more than half the states provided some type of state sponsored pool for those with serious health problems.

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