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

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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The lowdown...

  • Healthcare reform has determined that wellness checks after coverage begins are more helpful than initial health exams
  • Science has failed to prove a link between future health risk and health checks for generally healthy individuals
  • Conservatives and Liberals plan to maintain pre-existing condition coverage
  • Pre-existing Condition Coverage Plans were replaced by laws to protect those with existing health conditions in 2014
  • Check with your doctor about future medical service needs and costs before switching healthcare plans

Signing up for health insurance in days past meant having to undergo a health exam to determine your current state of health and what your risk of disease or illness might be.  The healthcare reform has done away with stipulations on pre-existing conditions.

No individual can be denied coverage, or be held at a higher premium based on an existing health problem as of 2017.

The Affordable care Act has done much to push healthcare in a positive direction. The debate about whether an initial health exam is important was washed away with rules and regulations that make it illegal to change the rate of insurance as a penalty for pre-existing conditions.

The government recognizes a better way to determine overall health by providing an annual wellness check-up.

Find coverage for all your medical needs by comparing free quotes in the box above!

Failure to Link Future Health Risk and Health Exam


There has been very little in the way of a scientific link in conducting an annual exam and being able to adequately determine future health risk. At best, it can useful to help monitor those that are already determined to be at risk for illness and disease. This is what has helped push for change in the healthcare law that look out for those that may not know they have impending health problems.

Health exams have not been proven to reduce incidences of illness, surgeries, hospitalizations and other treatments. Using an exam as a basis to determine future health risk for someone that is generally healthy has been proven ineffective. The ACA has determined that the funds for health checks are better spent after the coverage goes into effect.

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The Debate Over Pre-Existing Conditions

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As much as Conservative pushes to limit coverage for pre-existing conditions and Liberal individuals stand by doing away with limits and restrictions, neither will completely get their way. Slight alterations may happen to healthcare reform laws, but no one is willing to agree to restrict coverage from those with pre-existing conditions.

There may be some concessions made on a number of premium individuals pay for having existing health problems.

ACA Pre-Existing Condition Health Plans

Prior to the change in healthcare laws, the ACA provided Pre-existing Condition Healthcare Plans that bridged coverage for those that had been denied services through private insurance companies. This type of coverage plan ended in 2014 with the passage of laws that protect those with pre-existing conditions.

Many individuals were able to get needed coverage from a myriad of health insurance companies that offered affordable rates. Everyone that had signed up for this coverage was able to merge into more traditional healthcare plans.

Healthcare Reform and Pre-Existing Conditions


The health reform created a law that took effect in 2014 that makes it illegal for any health insurance company to deny policy coverage to anyone that has a pre-existing health condition. They are also unable to charge higher rates for those that have a previously diagnosed condition.

Rates cannot be raised, or coverage canceled due to seeking treatment and other medical services. Any raise in rates have to shared by everyone in that particular healthcare pool of individuals.

As long as someone has maintained their premium payments, the coverage has to stay in effect for the contracted period. COBRA coverage has to be offered if the individual loses group coverage through job loss.

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What should I consider when finding the right health insurance with existing health problems?


There are specifics you should keep in mind when shopping for the right health insurance policy while having existing health conditions that require treatment. You need to understand what services are provided and what your future healthcare needs will be. A few of things to keep in mind are:

  • Necessary preventative testing services
  • Costs of medications
  • Copay and deductible amounts
  • Number of allowed doctor visits
  • Appeals procedures for denied medical service coverage

You need to consult with your primary doctor before researching to find a different health plan. It helps to have an idea of what your future healthcare needs are with any existing and chronic medical condition. This will help you hone in on plans that are affordable and offer the services you need.

Finding Coverage for Your Unique Needs


There are protections in place for those that have pre-existing conditions and these protections are likely to remain intact, no matter how much debate swirls. There may be changes on the horizon for premium amounts, but the ability to get and maintain coverage will stay in place.

Contact an expert in pre-existing health condition coverage to see what affordable options are available today. Start here and enter your zip code below to get a comprehensive list of free, personalized health insurance quotes!