Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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Health insurance participant with pacemaker

It is possible to obtain health insurance with a pacemaker, but it will depend on your age, your health status, where you live, and your employment status/income level.

If you are over age 65, you should qualify for Medicare and you would most likely obtain a supplemental policy for your pacemaker care. If you are under 65, it will depend on what state you live in and your employer and/or income level.

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Insurance Options for Pacemaker Patients

If you are under 65 and offered health insurance through your employer, often times they have a group plan which accepts all employees, regardless of their health history.

If you are employed and your employer does not offer health insurance, you might have more difficulty obtaining a policy. This is also true if you are self-employed and seeking private health insurance.

States vary widely as far as private health insurance coverage is concerned. Their rules and conditions even differ between counties. For example, in some states, private health insurance companies will offer you health coverage when you have a pacemaker only if you are coming off COBRA within a certain time period or if you have been dropped from a state health program.

In other states, there is a selection of private health insurance companies willing to provide you with full health care coverage, but at a steep cost.

When you have a pacemaker, it is considered a pre-existing medical condition. If you are under the age of 65, it is often very difficult or extremely expensive to secure full health care coverage with a private health insurance company with a pre-existing condition.

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Pre-existing Medical Conditions

When your employer does not offer health insurance or you are self-employed and seeking health insurance, potential private health insurance providers will have you fill out a medical history report. Health insurance providers will sometimes have you fill this out even if your employer is offering you health coverage through a group plan.

A medical history report will ask you what illnesses or diseases you have or have been treated for in the past, the types of surgeries you have had, your family’s health history, and any other medical condition you have or have had to determine if you have a pre-existing medical condition.

A pre-existing medical condition is any type of illness, injury, surgery, disease or medical condition that you have now or have had in the past. When you have a pre-existing medical condition, health insurance providers are reluctant to cover the health care costs associated with the illness, disease, or condition. Having a pacemaker constitutes a pre-existing condition and therefore puts you in this category and the increased health insurance rates that go with it.

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Medical Release of Records

Health insurance companies normally do not deny coverage for a pre-existing condition without requesting further information from you and your medical health care provider(s). In most cases, health insurance companies will request you to sign a form to release your medical records and health history information from each doctor or medical professional that has treated your pre-existing condition. They then acquire these records to have them evaluated by a qualified health care professional. In doing so, they are trying to calculate your current status as a healthy individual while at the same time assessing their risk in providing you with health care coverage.

It is not guaranteed that health insurance providers will offer standard coverage to patients with a pre-existing condition like a pacemaker. However, health insurance companies may offer you a policy that covers everything but your pacemaker-related health care, or they may offer you complete health care insurance at a high cost. The type and extent of your health care coverage is going to depend largely on the state in which you live and the health insurance company you elect.

Health Insurance Coverage with Your State

Even if you fail to gain private health insurance coverage for your pre-existing condition, you may be eligible to obtain it through your state. Most states today offer health insurance coverage to residents under age 65 who are in within a certain income bracket. As with private health insurance carriers, states vary widely in their rules and conditions for health insurance coverage. You may inquire with your state health department to see if you qualify for reduced-rate or free health coverage through your state.

Before you choose a health insurance provider, make sure that you are getting all the health care coverage you will need to maintain your health. You can explore your options from different private health insurance providers right now by getting online insurance quotes.

Enter your zip code into  the tool on this page and get the rate quotes you need now!