You have probably heard in the news lately that individuals with pre-existing health conditions cannot get health insurance coverage. One would naturally think that those persons need coverage more than anyone, but let’s look further at this situation.

First of all, we need to define a couple of key terms:

*Pre-existing condition-Most insurers define it as a condition that manifested itself and required medical attention within a 12 month period prior to the insurance being purchased.

*Insurance-This is the transfer of a large uncertain potential loss to someone else (the insurance company) for a small predictable loss known as a premium.

If my house is on fire, can I call an insurance company and purchase a policy to cover the loss? Certainly not. If I just wrecked my car, can I call the auto insurance company and upgrade my coverage? Of course not. If a loved one in my family just died, can I then purchase a life insurance policy for them? That’s absurd. I think everyone realizes what a pre-existing condition is by these silly examples. Insurance companies are not in business to cover things that have already happened. Remember, insurance is to cover a large uncertain loss.

In Virginia and other states, there are insurance companies such as Anthem Blue Cross and Blue Shield that offer health insurance plans to individuals regardless of past medical conditions. These plans are known as open enrollment plans and there is no medical underwriting involved, therefore, health insurance is available to everyone regardless of the past health history. Most health insurance companies have a standard 12 month waiting period before the pre-existing conditions are covered and will give you credit for prior coverage with another insurer in some instances. This is one of the reasons for purchasing and maintaining health insurance coverage on a continual basis so that it can serve the purpose intended if needed.

Pre-existing health conditions should not prevent someone from purchasing individual health insurance and have coverage for those conditions. The only reason for these conditions to be excluded from coverage for 12 months is to prevent insurance abuse. None of us would purchase coverage until we needed it if insurance companies were required to cover losses that have already happened or started to happen. That’s not the purpose of insurance and insurance companies would all be bankrupt if it worked that way. Herein lies one of the problems in the current effort to reform health care by requiring that insurance companies cover pre-existing conditions, in other words, after the house is already on fire.