Healthy Tips

Follow this advice for finding affordable health coverage if you have medical conditions.

A few key strategies can help you find decent deals in health insurance, even if you have a medical condition:

  • Shop around. Each insurance company looks at medical conditions differently. Some may reject everyone with diabetes, for example, while others may accept people who control their condition through diet and oral medication. Some insurers may raise your rate by 25% to 50% for several years because of certain medical conditions -- back problems, for example -- while others may exclude coverage for anything related to your back. And each insurer has different cut-offs for cholesterol, blood pressure, height and weight.

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  • Get help. It's most efficient to shop around with the help of an expert who knows from experience which insurers are likely to accept someone with your condition. That way you can minimize the odds that you'll be rejected. If a rejection appears in your file, it can be more difficult to get insurance elsewhere. One good source of help is, which works with several insurers in most states (if you have a medical condition, call 800-977-8860 for personal attention rather than shopping online). Or find a health insurance broker in your area through the National Association of Health Underwriters.

  • Don't take no for an answer. If an insurer rejects you, find out why. You may be able to get that decision reversed by providing additional medical records, such as a doctor's note explaining how well you've been controlling your condition, or the circumstances under which you took a certain medication or sought counseling. And sometimes you'll find an error in the records, such as a wrong date, which is easy to clear up.

  • Don't give up COBRA. This federal law requires employers with 20 or more employees to let you continue coverage for up to 18 months under the company's group plan after you leave your job (or 36 months if you no longer qualify as a dependent). Some states have similar rules for smaller employers. The coverage can be expensive because you need to pay both the employee's and employer's share of the cost. But the insurer can't reject you or change your coverage because of your medical condition. Healthy people can often find a better deal on their own, but COBRA is often the best deal if you have a health problem. Before dropping COBRA, shop around to see if you qualify for individual coverage and how much you'll pay.

  • Know your state laws. Even if you have insurance through COBRA, the coverage runs out after 18 or 36 months. Give yourself plenty of time to learn about the alternatives, because rules vary by state. In 33 states, you can get coverage through the state high-risk pool, for which premiums will be 125% to 150% higher than with standard coverage. But some state pools have long waiting lists or, like Florida's, aren't open to new applicants. And several states, such as Arizona, Georgia and Nevada, don't have a high-risk pool. In those states, you may still have coverage options through the Health Insurance Portability and Accountability Act of 1996 (HIPAA). That law requires insurers to provide you with some type of coverage after you leave your job, as long as you had an eligible group policy and haven't been without coverage for more than 63 days in the preceding 18 months. Specifics vary by state. Ask your state insurance department about your options, or work with a local agent who knows the rules. NAHU's Consumer Information Center is also a good source of information.

  • Don't jump into the pool. Even if you qualify for coverage through your state's high-risk pool, don't be too quick to sign up. Even if you've been rejected by one or two insurers, you may still be able to find better coverage at a lower cost through a commercial insurer.

  • Stay vigilant. Your coverage options can improve over time. Some insurers, for example, will cover people with certain types of cancer after five or seven years have passed since the patient's last treatment. Or they may raise your rate by 20% to 50% for several years, after which they're willing to lower your premium-if you ask.your insurer to recheck your medical records. If that doesn't work, shop around for alternatives. Just don't drop your current policy until you know you've qualified for another one.

  • Compare coverage, not just price. Barebones policies with low premiums can end up being very expensive if you have a medical condition and exceed the coverage limits. It's generally more cost-effective to get a policy with a high deductible rather than one with lower premiums and lower coverage limits. You can also pair a high-deductible policy with a health savings account, which lets you use tax-free money to pay your medical bills. If you have expensive medications, add up your out-of-pocket costs for the drugs, not just the premiums on the policy, to come up with your total cost.