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Can I change health insurance plans if I have a pre-existing condition?

Yes. An insurance plan cannot reject you, charge you more or refuse to pay for essential health benefits for any condition you had before your coverage started, according to the Patient Protection and Affordable Care Act (PPACA). Furthermore, the PPACA requires that once you are enrolled, the plan can’t deny you coverage or raise your rates based only on your health.

The exception to this rule? Grandfathered plans (health plans that were created -- or individual health insurance policies that were purchased -- on or before March 23, 2010). Grandfathered plans don’t have to cover preventive care, and grandfathered individual plans don't have to cover you for preexisting conditions. If you have a grandfathered plan and want pre-existing conditions covered, you can:
  • Switch to a plan through the Health Insurance Marketplace during open enrollment that will cover you.
  • Buy a Marketplace plan outside open enrollment when your grandfathered plan year ends, and you can qualify for a special enrollment period.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.