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- Under the Affordable Care Act regulations, insurance companies cannot refuse to provide you with coverage or charge you more for coverage because you have a pre-existing condition, including type 1 diabetes
- Care for chronic conditions, such as type 1 diabetes, is considered one of the ten essential health benefits under the Affordable Care Act
- You typically will not get any financial help in paying for your health insurance if you have type 1 diabetes
- However, if your income is less than 400 percent of the federal poverty level, you should qualify for premium tax credits and cost-sharing assistance even if you have type 1 diabetes
- There are several different types of medical plans to choose from both on and off the Marketplace
- If you know you need to visit the doctor often in order to manage your type 1 diabetes, you should consider purchasing a plan that will cover most of these services even if it means a higher monthly premium and a lower deductible because it may save you money in the long run
Type 1 diabetes occurs when your body attacks the beta cells in your pancreas which makes it difficult for them to produce insulin. Insulin is important because your body needs it to move glucose into the tissues to create energy.
People with type 1 diabetes must put insulin injections in their body to help regulate their blood sugar. Those with type 1 diabetes will typically need health insurance to help cover these insulin injections and to help with the cost of regular check-ups with their doctor.
Find diabetes health insurance coverage by comparing free quotes typing your zip code into any of the boxes on this site!
Will my type 1 diabetes affect my ability to get coverage?
The new regulations under the Affordable Care Act ensure that health insurance companies must offer coverage to people with pre-existing conditions, including type 1 diabetes. They also cannot charge you more for your pre-existing condition. Additionally, insurance companies cannot raise your costs or deny you coverage for certain benefits once you are already enrolled in their plan.
Health insurance companies can only charge higher rates for age and tobacco use, as well as the size of your family and the location you live in.
The only exception to this rule is grandfathered health plans which do not have to comply with all of the Affordable Care Act guidelines. They do not have to provide you coverage if you have a pre-existing condition and they do not have to cover preventive services.
If you are a type 1 diabetic and have a grandfathered health insurance plan, you may want to consider switching to a Marketplace plan which will cover most of your diabetes needs.
Is coverage for type 1 diabetes considered an essential health benefit?
There are 10 essential health benefits categories that insurance companies must cover under the Affordable Care Act regulations. Preventive services, wellness visits, and management for chronic diseases must all be covered by your health insurance plan.
Some of these services may be covered at no out of pocket costs. Screenings and physicals are often covered free of charge so doctors can detect diabetes and any other disorders early and help you manage them at an affordable rate.
Other services that are considered essential health benefits include pediatric services, laboratory services, prescription drugs, hospitalization, and emergency services. These are important services as well because you may need prescription drug coverage to cover your insulin, laboratory services to test your insulin levels, and hospitalizations in the event of an emergency.
Is there financial assistance available to help pay for my coverage?
There is typically no financial assistance available specifically for people with certain disorders such as type 1 diabetes. However, there are premium tax credits available for those who make between 100 and 400 percent of the federal poverty level. This amount is based on the income you put down on your Marketplace application.
You can choose how you use your premium tax credits. You can choose to apply them to your health insurance costs in advance.
When you file your federal tax return, if you use more of your tax credits than you actually qualified for, you will have to pay that amount back.
If you used fewer tax credits than you qualified for, you will receive a refund of that amount when you file your federal tax returns. Although you can purchase your health insurance from a variety of sources, the Marketplace is the only place that you can get premium tax credits.
There are other cost savings available from the Marketplace for those who purchase Silver level plans.
Medical Insurance for Type 1 Diabetics
Under the Affordable Care Act, anyone with a pre-existing condition, including type 1 diabetes, is eligible for an insurance plan that should cover their medical needs
Enter your zip code below to compare free health insurance quotes and find diabetes coverage that fits your coverage today!
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