Pre-Existing Conditions and the Cave of Horrors

The New York Times has another informational article today, giving tips on how those with pre-existing conditions or urgent illnesses can find care in our broken health care system.  It reads like a horror novel.  It’s worth reminding ourselves how much our profit-driven system has created a series of challenges that turn ordinary medical disorders into potential death-traps.

The article offers helpful advice on what not to do with employer-based insurance (don't shop around for a better, cheaper option that covers less, or just don't be unaware that under HIPAA law, the employer has to offer you their plan).  It explains the ticking time bomb scenario of being between plans for even as short a time as 63 days.  It discusses the “last-gasp” state GAP coverage plans, designed for those who can’t get an insurer to cover them any other way, but unfortunately likely to be “prohibitively expensive.”  There’s group coverage through trade associations or other pooling mechanisms, but they’re rife with “fraud and insolvencies.”  There are temporary policies – a bargain rate for a year or six months – but whose renewal is not guaranteed.  As the article says, “But if you get sick or injured while holding one of these policies… the insurer will most likely deny you coverage when you try to renew — because now you have a pre-existing condition.”  Finally, there’s the myriad ways an insurer can cancel your policy upon any discrepancy in your application and your medical history, intentional or not, or based on any pre-existing condition – real or imagined.

Trying to find coverage that you can afford and won’t be yanked out from under you is like the world’s worst video game – there is only one successful path to navigate the dangers, but a myriad number of corners, traps, misdirection and surprises.  Only unlike a videogame, the stakes are far from ephemeral – they’re your health, your financial security and even your life.

(Photo credit:  karen_d on Flickr.)