May 29, 2024

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The Importance of Insurance for Those with Chronic Conditions

3 min read
Chronic Conditions

Healthcare insurance is a necessary expense in the United States as it protects the individual from huge bills for medical treatment. Even those who are young and in good health should have medical insurance as no one can predict what will happen in the future. There is always the risk of an accident or illness occurring, even in those who least expect it.

Chronic disease is a major problem in the U.S., and it is typically caused by an unhealthy lifestyle. Abuse of alcohol, tobacco, and junk food, in conjunction with physical inactivity, is playing havoc with the health of the nation and many are suffering a variety of preventable diseases. For these individuals, health insurance is more important than ever.

Chronic diseases include cancer, asthma, cardiovascular disease, arthritis, diabetes, and chronic obstructive pulmonary disease. Unfortunately, one out of every two adults in the U.S. reports having at least one of these illnesses.  These conditions are costing billions in healthcare every single year and without insurance, many of those affected could be faced with financial ruin.

Does Health Insurance Cover Chronic Conditions?

Since the introduction of the Affordable Care Act (ACA) in 2010, most healthcare plans must cover a specific list of health benefits, including the management of chronic conditions. So, most plans will provide cover for visits to the doctor, laboratory testing, prescription medication, rehabilitation, behavioral health services, and hospital care.

However, plans which were taken out before the ACA and that have not changed since may not cover the management of chronic health conditions.

It is important to note that even though healthcare plans must include cover for essential benefits, not all plans will provide the same cover. Every state can make decisions about what insurance providers must include, such as the specific services and the level of cover to be provided.

Plans that cover chronic conditions may differ from state to state in terms of cover for medication for example, with some states specifying that a range of medications must be included and others only choosing to insist on cover for a few.

It is important to find out what your healthcare insurance plan covers, particularly if you are suffering with a chronic condition. It would be best to speak to your insurance provider and explain what type of illness you have and the likely cover you will need, including any medications your doctor has prescribed and any testing that has been recommended.

When talking to your insurance company, you might find it easier to use the medical billing codes associated with the condition you have. You can use an online database such as that at to access this information quickly and easily.

What if You Don’t have Insurance?

Without insurance, you could face financial hardship if you develop a chronic condition as it will usually require ongoing management and treatment. If you have had a specific health problem for at least a year that requires continual medical attention or that is limiting your daily life, it is usually classed as chronic.

The average yearly cost to treat a patient with chronic health conditions is $6,032. This amount would be far higher for those suffering conditions such as cancer or cardiovascular disease. Most people could never afford to cover the cost of treatment and medical services associated with chronic health conditions, making healthcare insurance extremely important.

With healthcare insurance, free preventative care is usually covered, allowing for screenings and checkups that could help to prevent some chronic conditions. Those who do go on to develop a chronic condition such as cancer will be protected from high medical bills.

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