Many individuals with pre-existing medical conditions face the challenge of finding affordable medical insurance in the U.S. Those with pre-existing chronic conditions are often declined coverage from health insurance companies altogether. According to the Affordable Care Act, health insurance companies are required to offer anyone with pre-existing conditions coverage.
Many insurers have tried to get around this by restricting or excluding the most commonly performed procedures for people with pre-existing conditions, including organ transplants, chemotherapy, dialysis, and mental health care. Some patients face denial of coverage since insurers assume they will be more expensive to insure due to their current health condition. Here are some potential medical health insurance issues for patients with these pre-existing health conditions:

1. Multiple sclerosis
If you have multiple sclerosis (MS), you’re probably already aware of how challenging it can be to get and stay covered. According to The National Multiple Sclerosis Society, close to a million Americans suffer from MS. Yet thanks to their pre-existing condition, only a fraction of them can afford private insurance, and even then, not always for all of their medical needs. For example, a study published in 2016 revealed that depending on the severity of the disease, annual healthcare costs can range from $30,000 to $100,000 USD for MS patients.

2. Asthma
According to the Asthma and Allergy Foundation of America, roughly 25 million Americans (or 1 in 3) have asthma. Due to symptoms such as  breathing difficulties, chest tightness, excess mucus, and coughing, many asthma patients require ongoing medication (i.e., rescue inhalers) and therapies to manage their condition. This means it can be challenging for those diagnosed to get health insurance. The CDC says it’s vital for asthma patients to have health insurance, and that gaps in coverage can have significant adverse health consequences. A 2015 study published by Allergy Asthma Immunology, noted that pediatric asthma patients with Medicaid coverage used more emergency and inpatient services for asthma compared to children with private insurance.

3. High cholesterol
Most people may know high levels of cholesterol can be a significant health risk. However, many don’t realize that it can also hurt your ability to get affordable medical insurance. If you have a history of high cholesterol, and are taking drugs to control your cholesterol levels, your health premiums could be more expensive compared to individuals with healthy, or even lower, cholesterol levels, which is why it’s important to secure health insurance before you develop chronic health conditions. For instance, a medical examination is very common in the health insurance underwriting process, which means if you’re getting new insurance,insurance companies may take your age, medical history and even lifestyle choices (i.e., smoking) into consideration. High cholesterol is considered a risk factor for a heart attack or stroke, both leading causes of hospitalizations, surgeries, and deaths in the U.S. So be sure your cholesterol is under control (i.e., medication or lifestyle changes) prior to seeking a new health insurance policy, or you could be denied coverage.

4. Arthritis
Arthritis is an umbrella term used to characterize over 100 medical conditions that cause joint pain and inflammation. Certain types of arthritis, such as rheumatoid arthritis (RA), can also affect internal organs like your lungs or heart. If you have been diagnosed with arthritis, you may have issues finding affordable health insurance coverage because insurance companies may consider your pre-existing condition a potential future problem. Twenty-one percent of individuals who took part in a 1995 study had limitations on their insurance covers due to arthritis. Be aware that with pre-existing arthritis, patients need to disclose their specific type of arthritis with insurance providers (i.e., osteoarthritis, rheumatoid arthritis, or psoriatic arthritis). According to data collected by the Arthritis Health Professions Association, even RA patients with excellent health insurance plans, experience limitations receiving rheumatologist care due to their preexisting condition disclosure, which lead to considerable financial impact.

5. Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease, or COPD, is a group of inflammatory lung diseases that make it hard to breathe. COPD may be characterized as emphysema or chronic bronchitis. COPD and other lung diseases, like asthma, can make it difficult to get affordable health insurance coverage. While you may still obtain coverage, you may need to improve your health to lower your premiums. Literature from the American Lung Association (ALC) offers COPD patients guidance when it comes to securing health plans and managing costs under the Affordable Care Act (ACA). The ALC doesn’t recommend delaying care to avoid co-payments or other out-of-pocket expenses as delay in treatment may lead to worse health outcomes. Instead, the ALC suggests patients try to accurately estimate their upfront health care costs so they can pick the best plan to cover their needs so they don’t cover too many out-of-pocket costs.