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A proposed insured for a health insurance policy was treated for heart disease within the past year. When applying for health insurance, the heart disease treatment: A. May result in a higher premium or coverage limitations.

B. Will not impact the health insurance application.
C. Automatically disqualifies the individual from obtaining health insurance.
D. Requires a separate heart disease insurance policy.

User Mieko
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1 Answer

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Final answer:

An individual treated for heart disease within the past year when applying for health insurance may face higher premiums or coverage limitations due to the assessment of their risk by insurance companies.

Step-by-step explanation:

The treatment for heart disease within the past year may result in a higher premium or coverage limitations when applying for a health insurance policy. This is because insurance companies often assess the risk of an individual based on their pre-existing medical conditions, which can lead to costlier premiums or even denial of coverage in some cases. People purchasing health insurance with known conditions, such as heart disease, are considered higher risk compared to those without such conditions. In an attempt to set premiums at actuarially fair levels, insurers might charge higher rates to individuals with a history of serious health issues.

Historically, before reforms like the Affordable Care Act (ACA), individuals with pre-existing conditions faced significant challenges in obtaining and affording insurance coverage. Post-ACA, while there have been changes to how insurers can use pre-existing conditions in determining coverage and pricing, the underlying principle of risk-based pricing still applies, and thus those with recent treatment for heart disease could face higher costs.

User Collimarco
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