Finding short-term coverage with a preexisting condition

With a chronic health issue, know what to ask about the right plan for you

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When you don’t want to risk your health by going without coverage, short-term health plans can be a great option. However, having a preexisting condition or symptom can make getting your care covered through a short-term health plan a challenge.

There are good reasons to consider such a plan anyway, but you should always go into health care decisions with all the information you need to make the right call for you.

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A preexisting condition is any medical concern, health problem or injury that occurred before you enroll in a new health plan. These conditions often require a diagnosis, further care and/or ongoing treatment. While not a comprehensive list, some examples of preexisting conditions include:

  • Arthritis
  • Cancer
  • Diabetes
  • Dementia and Alzheimer’s disease
  • Depression and mental health disorders
  • Heart and cardiovascular disease
  • Pregnancy

Preexisting conditions and the ACA

In most situations, under the Patient Protection and Affordable Care Act (ACA), health insurance companies cannot charge you more, deny you coverage or require a waiting period before coverage begins because of a preexisting condition. Short-term health plans are an exception to this rule.

Since they are temporary — lasting 12 months or less — they do not provide comprehensive coverage, nor do they meet the minimum essential coverage requirements of the ACA. As a result, they are exempt from the ACA rule.

Typically, short-term health plans either limit coverage for preexisting conditions by denying their application altogether or by excluding coverage for preexisting conditions and their care. Should a health insurance company approve you for a short-term health plan despite a preexisting condition, your coverage would only apply to care that is not related to your preexisting condition.

Despite this, a short-term health plan may be the right choice for you. With short-term health plans, like Sanford Safeguard, you can get instant access to affordable health coverage during periods where you are without health insurance, such as:

  • Between jobs
  • Between semesters in school
  • When waiting for coverage to begin
  • When waiting for open enrollment

Benefits of short-term health plans

Even if you have a preexisting condition, your coverage can start as early as the day after you receive approval. This means you have immediate protection in the event of an emergency or unexpected illness or injury. In addition to quick access to care, short-term health plans offer an exceptionally low monthly premium.

Sanford Safeguard has a broad network of 25,000 primary and specialty providers across Iowa, Minnesota, North Dakota and South Dakota. Plus, coverage that includes:

  • A $50 co-pay doctor’s visit (limited to one co-pay visit per three months, and coverage is for participating providers only)
  • Emergency room and ambulance coverage
  • Urgent care benefits
  • $0 virtual care
  • Member discounts on hearing, vision and dental services

Anyone age 18 to 64 years who lives in North Dakota or South Dakota can apply for Sanford Safeguard to cover yourself, your spouse (between the ages of 18 to 64) and/or your dependent children under the age of 26.

To learn more about Sanford Safeguard, talk to a local agent at (888) 535-4831. Our certified experts are here to help you make the best decision for your needs, budget and family.

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Posted In Health Plan