Until 2014, staying insured with a pre-existing condition will depend on what state you live in. By Kimberly Lankford, Contributing Editor August 3, 2012 I have a serious medical condition, and I would like to change jobs. Is there a way that I can keep my old coverage if my new employer doesn't offer health insurance? I can't afford to lose my medical insurance, and I would be denied coverage by insurance companies if I tried to buy it on my own. Starting in 2014, insurers will no longer be able to reject anyone for coverage or charge a higher rate because of a preexisting condition. A few states, such as New York and New Jersey, already have this requirement. If you live in another state, several consumer protections can help you keep your coverage through a former employer. Employers with 20 or more employees usually must let you continue the insurance through the federal law known as COBRA. You can continue your coverage for up to 18 months after you leave your job (some states have similar rules, called “mini-COBRA coverage,” for smaller employers). Your premiums will increase because you'll have to pay both the employer's and the employee's share of the cost, plus a 2% administrative fee, but you can't be rejected because of your health. When you leave your job, your employer is required to send you written notice explaining your rights under COBRA. You have up to 60 days after you receive the notice to sign up. (See the Department of Labor's COBRA fact sheet for more information.) After you exhaust that coverage, or if you worked for a small employer that doesn't offer COBRA, you can get a "HIPAA-eligible policy." This coverage, created by the federal law known as HIPAA, varies by state. Some states require insurers to provide policies that pick up after COBRA, or they; others designate a few companies to cover everyone, regardless of health. If you don't qualify for one of those options, you might be able to get coverage through a state high-risk insurance pool. The state pools created by the health care reform law, called preexisting condition insurance plans, require you to be uninsured for six months before you can sign up. But many states already had their own pools. Those pools may have higher rates than the one created by the health care act, but they generally impose no waiting period. To find out about the high-risk-pool and HIPAA coverage in your state and other consumer protections, see CoverageForAll.org and HealthCare.gov. Got a question? Ask Kim at firstname.lastname@example.org.