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This Web site contains a compilation of more than a thousand consumer finance  columns written by Tony Novak from the 1980s through 2006, updated and reformatted for maximum usefulness today.  New material was added after 2010.

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High blood pressure

originally posted: 11/22/2006  reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If you notice an error or are in doubt, please send a new question by email or ask for an update. Email

Q: I contacted someone regarding health insurance and it appears as if Anthem Blue Cross is the only option for Virginia. I asked about whether they would require a waiting period for a pre-existing condition and the sales person said that the only way to know whether a waiting period would be required is by actually applying for the insurance. However, I don't want to go through the whole process of applying unless there is a high level of likelihood of not having a waiting period, since I can already get travel insurance with a 3 month waiting period. In addition, I am concerned about applying for insurance at this point, being granted the insurance with a waiting period, then turning it down. My concern is that this will bias any future applications I may make for health insurance once my health has stabilized--which will probably be within 1-3 months. Can you tell me, from your experience, what the likelihood is that Anthem will require a waiting period for a pre-existing condition of high blood pressure? Do you need more information to assess this for me?

A: You have included a number of comments that add up to a likely misunderstanding of health insurance as it relates to high blood pressure (HBP) coverage. This discussion presumes that the condition is controlled with medication, as is the case in the vast majority of cases. (Uncontrolled HBP, on the other hand, is an entirely different matter not discussed in this article). HBP is always a pre-existing condition and it is always excluded from coverage except 1) in a HIPAA plan like the one you indicated, or 2) when a policy does not include prescription drug coverage, the coverage may be issued "Standard". The length of the exclusion depends on your "Certificate of Creditable Coverage". In other words, if you had no prior insurance coverage (and therefore no Certificate) prior to the new policy, then the maximum waiting period is imposed, usually 12 months, but this may vary. If you had more than 18 months continuous prior insurance coverage documented on one or more Certificates, then there is no new waiting period. If you had some coverage, but less than 18 months, then the waiting period will be adjusted accordingly. Some of this is subject to local variation and the insurer will want to see your documentation prior to giving a specific offer. See the article "Understanding a Certificate of Creditable Coverage" for more information. Travel insurance will not cover pre-existing conditions while you are at home. Specifically, travel insurance would not cover a refill of the HPB prescription unless you were overseas for an extended trip. In most cases the approach used by HPB patients - when this is the only significant medical issue - is to apply for a lower cost policy (not the HIPAA plan) that excludes coverage for the medication but provides better overall coverage for all other risks at a lower price. See for more information. HBP will remain as part of your Medical Information Bureau records for 3-5 years as a matter of fact, and probably longer as a mater of medical probability. It is not realistic to think that this issue will disappear as a "pre-existing medical condition" anytime soon. The HIPAA plan through Blue Cross is generally used by people with very expensive current treatment like diabetics, cancer patients, etc., not commonly used for a healthy person with HBP so perhaps it would make sense to reconsider your approach by talking with your physician about the potential costs of treating HBP. A common misconception is that insurance would not cover a medical condition associated with HBP, like heart disease or stroke, due to an exclusion on HBP as a pre-existing condition. This is not the case. Once you realize how small the costs of treating HBP are and how easily they can be handled outside of insurance, you would not likely want the right risk pool type of insurance that Blue Cross offers. In summary, HBP is not usually a significant issue when considering individual health insurance just understand that it is not in your best interest to try to get the insurance to pay for your prescription medication.


More resources:

Understanding a "Certificate of Creditable Coverage" Health Insurance for Applicants With High Blood Pressure