Recent changes in healthcare laws due to the Patient Protection and Affordable Care Act (PPACA) require that insurance companies cannot deny children coverage because of pre-existing medical conditions. However, as of now, children must be enrolled on the same policy as a parent that is approved through medical underwriting. If no parent on the application is approved, the child(ren) can still be denied coverage.
So the question becomes…which company will offer the best rate if your child would have otherwise been uninsurable based on their medical history? Every Virginia health insurance company does their underwriting differently. Anthem Blue Cross/Blue Shield will assign a “Level 4” risk class (they use Levels 1-3 for those who can pass underwriting). Most other companies will assign a rate adjustment, usually between 100-400% of the standard premium. Some companies, such as Aetna, assign the rate adjustment to the entire family’s rate instead of on just the individual person. United Health One / United Healthcare and Humana One are also competitive.
The best choice will be based on a combination of factors – what are the standard premiums for the plan you are choosing? What is the deductible? How would your child’s prescriptions be covered? What is the specific medical condition? As an example, while Anthem will always assign Level 4 for uninsurable children, other companies’ adjustments may vary (ex: 100% for one condition, 300% for a different condition, etc).
If you have a child with major pre-existing conditions or are having trouble securing affordable Virginia health insurance, please give us a call at 1- and we’ll be happy to help. Send us an e-mail by clicking here.