A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Call our agency partners 866-553-3223

Medicare & Medicaid

Medicare & Medicaid

Featured

Featured
ACA open enrollment: what’s new for 2025
Open enrollment for 2025 ACA (Affordable Care Act)-compliant health insurance is just around the corner. Let’s take a look at the various changes that consumers should be aware of this fall.

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Featured
Fact check: Is the $6,400 subsidy real?
Ads on social media – promising a $6,400 subsidy – have been flagged as misleading. Here's what you need to know about the $6,400 subsidy scam.

Is there any chance I will be turned down for coverage by a health insurance exchange?

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Is there any chance I will be turned down for coverage by a health insurance exchange?

The main idea behind the Affordable Care Act was to remove the barriers to insurance coverage for most Americans who remained uninsured because of pre-existing conditions or issues of cost.

The law removed most of those barriers. So not only can a plan sold through your state’s health insurance exchange plan not turn you down because of a pre-existing condition, it also won’t exclude pre-existing conditions from your coverage or charge you higher premiums based on your medical history. These regulations apply to all individual major medical health insurance, regardless of whether they’re sold through the exchange or off-exchange.

The ACA includes a Patients’ Bill of Rights that helps consumers in a number of other ways, such as:

Limited enrollment windows

It’s important to understand, however, that health insurance is now typically only available for purchase during open enrollment or a special enrollment period. Most special enrollment periods require a qualifying life event.

These limited enrollment windows apply both on and off the exchange. If you try to enroll outside of open enrollment, without being eligible for a special enrollment period, you will not be able to complete the enrollment. So while the days of getting turned down because of medical history are long gone, it’s still possible to be turned down for health insurance, based on when you apply.

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