The healthcare system is critical to the well-being of individuals. Health insurance policies provided by the regulatory bodies are supposed to cover all kinds of medical issues and assure the health and security of individuals.

Chronic diseases, however, could be a significant issue, and the coverage of chronic illnesses is always a concern, especially for individuals with a history of chronic diseases or those who are genetically inclined towards them. This article aims to explore the concept of chronic diseases in health insurance policies and the coverage of the same.

What are Chronic Diseases?

Chronic diseases are those that typically last more than a year and cannot be cured or entirely eliminated. Such conditions require long-term management and can be fatal if left untreated. A few examples of chronic illnesses include:.

Cardiovascular disease
Cancer
Chronic obstructive pulmonary disease (COPD)
Diabetes
Hypertension
Arthritis

Understanding Chronic Disease Coverage in Health Insurance Policies

The primary aim of healthcare insurance policies is to ensure the good health of individuals by covering costs related to treatments and procedures. However, coverage for chronic diseases varies from plan to plan and state to state.

There are several criteria that health insurance policies consider when determining the coverage of chronic illnesses.

Pre-existing Conditions

If you are at risk of developing chronic diseases, insurers might limit coverage or entirely exclude it, citing pre-existing conditions.

This is because the insurance companies are in the business of preventing future costs by avoiding high-risk situations. Hence, pre-existing conditions feature prominently when it comes to health insurance policies covering chronic illnesses.

The Type of Health Plan

Chronic illnesses can be expensive to diagnose and treat, and therefore, health insurance plans that cover chronic diseases are generally on the expensive side.

In recent years, there has been a push towards insurance policies providing enhanced coverage in different areas such as preventative, emergency, hospitalization, prescription drugs, and specialty medical care for chronic illnesses.

State Requirements

States play a vital role in the coverage of individuals with chronic diseases. They acknowledge the special needs of individuals with chronic illnesses and develop programs and policies that support them.

The policies vary from state to state, and there are several state regulations in place that provide additional coverage benefits for chronic diseases.

Laws Affecting Health Insurance Policies Covering Chronic Diseases

The government has implemented a few laws and regulations pertaining to healthcare insurance plans to make insurance companies accountable and maintain consistency in how health insurance policies are structured and provided to subscribers.

A few examples include:.

The Affordable Care Act (ACA)
Health Insurance Portability and Accountability Act (HIPAA)
Patient Protection and Affordable Care Act (PPACA)

Chronic Disease and Health Insurance Costs

Chronic diseases can create significant financial burdens on families who bear the brunt of healthcare costs.

Given the nature of the disease, care needs to extend throughout the life span, including continuing care even after the traditional working years. The costs can accumulate and threaten the financial stability of the family. The costs that the insurance carrier covers vary, but the responsibility always lies with the individual when the carrier provides insufficient coverage.

Conclusion

Chronic diseases are an ever-increasing concern in today’s healthcare world and can have significant financial and emotional impacts on patients and their families.

The coverage of chronic diseases by health insurance policies is a major concern that needs more attention from regulatory bodies. Health insurance plans must prioritize the coverage of chronic illnesses, and stringent measures must be taken to ensure the protection of individuals suffering from them.