Can I Get Health Insurance If I Have Preexisting Conditions?

Getting health insurance in Texas when you already have a preexisting medical condition can feel complicated, but it’s absolutely possible. While some insurance companies may apply restrictions or exclusions, federal laws now protect most people with health issues from being denied coverage.

Take care of your health and your finances. Compare health insurance options in the U.S. and find a plan that fits your needs and budget.

What Is a Preexisting Condition?

A preexisting condition is any chronic illness, medical diagnosis, or past health issue that existed before applying for a new health insurance plan.

Common examples include:

• Diabetes
• High blood pressure (hypertension)
• Heart disease
• Cancer
• Chronic obstructive pulmonary disease (COPD)
• Autoimmune diseases such as lupus or rheumatoid arthritis

When you apply for a health plan, the insurance provider may ask questions about your medical history. However, under the Affordable Care Act (ACA), insurance companies can’t deny coverage or charge you more just because you have a preexisting condition.

Why Do Some Plans Limit Coverage?

In the United States, all ACA-compliant plans (those available through the Health Insurance Marketplace) must accept people with preexisting conditions. However, short-term health plans or non-Marketplace options may still have coverage limits or exclusions.

That means:

• You might not be covered for treatments related to your condition.
• The insurer could set a waiting period before coverage starts.
• Certain prescription medications might not be included.

For example, someone with diabetes who applies for a short-term plan might have to pay out of pocket for insulin or specialist visits.

In Texas, having access to reliable health insurance can make a huge difference in managing ongoing medical care and avoiding expensive hospital bills.

Which Insurance Options Accept People With Preexisting Conditions?

Even if your health situation is complex, there are several coverage options available in Texas:

1. Marketplace Health Plans (Obamacare)

• All plans sold through must cover preexisting conditions with no waiting period.
• These plans include essential benefits like hospital care, prescription drugs, and preventive services.
• You can apply during Open Enrollment (Nov–Jan) or after certain life events (like losing job coverage).

2. Medicaid and CHIP

• If your income is limited, you may qualify for Texas Medicaid or CHIP (Children’s Health Insurance Program).
• These programs provide low-cost or free coverage, even for families dealing with chronic conditions.

3. Employer-Sponsored Health Insurance

• Most jobs that offer health benefits can’t deny you coverage because of your medical history.
• It’s a good option if your employer helps pay for part of the monthly premium.

4. Private Health Insurance

• Some private companies in Texas offer customized plans, including HMO, PPO, and EPO options.
• While these must follow ACA rules if they’re full-coverage plans, short-term or supplemental policies may still exclude preexisting conditions.

What If You Can’t Get Private Health Insurance?

If you don’t qualify for traditional coverage or find the premiums too high, consider these alternatives:

1. Short-Term Health Plans

Provide temporary coverage (up to 12 months), but often exclude preexisting conditions and limit benefits.

2. Fixed Indemnity Plans

Pay a set amount for specific medical services, but don’t fully cover ongoing treatments.

3. Health-Sharing Ministries

These are not insurance but member-based programs that help share medical costs. Coverage is not guaranteed for chronic conditions.

Before enrolling, always review the policy details, understand what’s covered, and verify that your doctors and medications are in-network.

Your health is your greatest asset. Compare the best health insurance plans in the U.S. and choose the one that keeps you and your family protected — no matter your medical history.