Tips for getting insurance when you have a pre-existing condition

Nineteen-year-old Stuart Wald is not likely to grow out of his schizophrenia, bipolar disease and attention-deficit disorder. But he will, with 100 percent certainty, grow out of the health insurance coverage he has through his father's employer -- and that day is just a few years away.

The Walds (not their real name) know he'll never get insurance on his own because he has not just one but three pre-existing conditions. Without insurance, it will cost the Walds thousands of dollars a month for his treatment and care.

If Stuart could get insurance through his own employer, that would solve the problem. With "group insurance," you can't be denied coverage because of pre-existing conditions. But millions of people can't get insurance through a job for a variety of reasons: They're self-employed, or their employer doesn't offer health insurance, or, like Stuart, they're too sick to work.

That's when they're forced to find insurance on the "individual" market.

Our "Empowered Patient" inbox is filled with desperate pleas from people with pre-existing conditions searching for individual insurance. As a matter of fact, we get more e-mail on this topic than on any other.

Stuart's father, Nathan Wald, wrote to us a few weeks ago.

"He needs lifelong medications and psychiatric therapy," Wald wrote. "Can you give us advice on how he can get benefits?"

According to the Kaiser Family Foundation, 21 percent of people who apply for health insurance on their own get turned down, charged a higher price or offered a plan that excludes coverage for their pre-existing condition.

"It's a huge problem, because insurance companies don't want to insure sick people," said Nancy Metcalf, senior program editor for Consumer Reports. "They're a business. They don't want to insure people they know are going to cost them a lot of money."

The health insurance industry doesn't deny that people are rejected or charged higher premiums because of pre-existing conditions.

The industry's trade association, America's Health Insurance Plans, has a proposal to help people with pre-existing conditions as part of a comprehensive health-care reform plan.