Health Insurance with a congenital heart defect?

Question

I need to purchase private health insurance for my son, who was born with a congenital heart defect. He has had surgery to correct (3 years ago) and requires no additional treatment. He does see a cardiologist once a year, though, strictly routine.

Two questions: (1) Is health insurance like credit cards, i.e. if you apply to too many, it looks bad on your record?


(2) Does anyone know of an insurance company and/or plan that would likely accept him? He's been denied coverage by one, but I don't want to keep applying if it will ultimately hurt his record.

Thank you.

Answer 1

1. No.

2. Assuming he's a minor, he's going to have a really, really, really hard time finding a private company to take him. SO, he's the perfect candidate to apply under your state Children's Health Insurance Program. They WILL take him - if you let them know about the heart issue, they MIGHT qualify him based on his OWN income, and not the family income.

If he's not a minor, his only bet is likely to be through his employer's group plan. Sure, they'll exclude anything heart related for 18 months or so, but then they'll cover it after that.

Answer 2

Applying to multiple insurance companies and being denied would not have an adverse effect, at least in Arizona.
In my opinion your best bet is to apply with the Blue Cross Blue Shield in your state. If this is the company that has denied coverage, bring this to the attention of the medical director of your local Blue Cross. Each Blue Cross is separately owned and operated, and most are non-profit. Though the underwriting guidelines may be that this condition is an automatic denial, the medical director, (who is most likely a physician,) has the ability to approve applications on a case by case basis.
Have complete medical records at the ready.
It has been my experience with very similar cases that a, "no," isn't always a no. If it is at all possible for Blue Cross to help, I am sure they will.

Answer 3

First of all this is a pre existing condition, and that is excluded on most insurance plans. now that ive said that, there is one company that I know of that will accept you without a physical exam, no medical records.
Its called Golden Rule insurance, they are based out of Cincinnati....there toll free # is 800-297-4189, that will get you to customer service and they can advise you where to go from there. Since they do accept most pre existing conditions the rates will be higher, and most if not all services will have to be pre certified with a third party review company, this just makes it so that the treatment that is being provided is "medically necessary for him. My best advice would be to give them a call and see where that gets you.

Answer 4

any claim in connection with his heart disease wont be claimable. Before getting an insurance policy for him, he will be going through a series of test before the insurance company issue a policy for him. Too tough though and you'll pay high on this plans.

Answer 5

I don't think you son will ever be able to get major medical,
but there is one company that does take people with health issues that is a good hospital surgical policy. Also there is an association that you can join to get some discounts ect. You can e-mail me and I can get you the information.

Answer 6

Best way to health insurance is through an employer .
Even if accepted , your premiums could easily be $500 a month .
And usually , if denied by one , no one else will take it on either .

Get a job that has health insurance .

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Answer 7

My son has had Five heart surgeries by the age of 5 Im a pro at this, Generally no they are not going to cover him maybe in so many years after surgery and with a waithing period to cover heart, Your best bet is Medicaid, or SSI, which comes with medicaid, please email me what state you are in how many in your family, age of your son, and the name of his heart cond. I will send you some info along with more questions, LOL Stacey [e-mail]

Answer 8

With Aplan, everyone is accepted and its very affordable. There no waiting periods. Check it out

Also I am going to include IAB. They are a little more expensive, but you have more insured benefits with them. Like I mentioned before everyone is accepted with our health coverage.