Getting Insurance When You Have a Health Problem

Medically Reviewed by Sarah Goodell on June 20, 2022

For anyone living with a health condition, from asthma to diabetes to cancer, it’s a terrifying thought. What if I lose my health insurance? What would happen to my finances? My health? My family?

Prior to the passage of the Affordable Care Act (ACA), insurance companies could charge people with pre-existing conditions whatever they wanted or deny them coverage altogether. One of the most popular features of the ACA is the ban on pre-existing condition exclusions. In addition, plans are no longer allowed to base your premiums on your medical history. This levels the playing field between those who are fortunate to be in good health and those who have not been as lucky.

There is an exception to this feature, however. Short-term health plans (those providing coverage for less than 12 months) and grandfathered health plans (those in effect since March 2010 that have not been substantially changed) can still exclude pre-existing conditions or charge more for them.

Show Sources


Alwyn Cassil, director of public affairs, Center for Studying Health System Change, Washington, D.C.

Nicole Duritz, health care portfolio director, AARP, Washington, D.C.

Stephen C. Schoenbaum, MD, executive vice president for programs , director of the Commission on a High Performance Health System, the Commonwealth Fund, New York.

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American Cancer Society: “Health Insurance and Financial Assistance for the Cancer Patient.”

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The Commonwealth Fund: “Health Care Reform is Not a Spectator Sport.” 

The Commonwealth Fund: “Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families.”

Consumer Reports: “Six Tips for Buying Individual Insurance.”

Families USA: “HIPAA Definitions.” “Coverage Denied.”

Kaiser Family Foundation: “The Uninsured: A Primer.” 

Kaiser Family Foundation: “How Private Health Coverage Works.” 

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Underwood, A. “A Health Insurance Exchange: The Fine Print,” New York Times, Aug. 20, 2009.

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