Pre-Existing Conditions (2024)

FAQs

Pre-Existing Conditions? ›

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more.

A pre-existing medical condition (PEMC) is an illness or injury you had before your policy began or was renewed. Examples of pre-existing medical conditions include, diabetes, asthma, high cholesterol or a long-term back condition.

A medical illness or injury that you have before you start a new health care plan may be considered a pre-existing condition. Conditions like diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea, may be examples of pre-existing health conditions.

Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

Moratorium underwriting

They may also speak to your doctor. We don't normally cover pre-existing conditions, which is any disease, illness, or injury you've had symptoms, medication, tests, treatment or advice for in the five years before you take out cover.

Post-claims underwriting can also be used by these non-ACA-compliant plans, meaning that they'll accept most applicants with little in the way of upfront underwriting, but will then do a thorough check of the person's medical history if and when they have a medical claim; if the condition is determined to be pre- ...

It's in their best interest, therefore, to exclude people with pre-existing conditions (or make the coverage unappealing to them), impose a waiting period before coverage starts, or charge higher premiums and out-of-pocket expenses to cover people with pre-existing conditions since those people are likely to cost the ...

A pre-existing condition could be known to the person – for example, if she knows she is pregnant already. People might also apply for coverage when they unknowingly have an undiagnosed condition – for example, tumor cells might be growing within but won't be diagnosed until months or years later.

Existing is a certain thing that is present nowadays and can be seen in present time. Preexisting refers to something that has existed a long time ago, and forgotten, and has existed once more in our present time.

Pre-Existing Conditions

A pre-existing condition is a health problem that already existed (officially diagnosed or just symptomatic) before you apply for a health insurance policy or enroll in a new health plan. Practically any medical issue could fall under the umbrella of a pre-existing condition in the pre-ACA days.

Why can't pre-existing claims be denied? ›

Under federal law, a health insurance company cannot refuse to cover you or charge you more based on a pre-existing condition. A “pre-existing condition” is a health problem you had before the date your new coverage starts.

Pre-existing diseases or PED is a kind of chronic or long-term medical condition which already exists at the time when one buys a health insurance. The most common examples of pre-existing diseases are: High blood pressure.

Prospective and current employees are protected from discrimination because of an illness or injury. This means asking an applicant to disclose a pre-existing medical condition or injury and then declining to offer them employment on that basis will be unlawful, unless an exception applies.

In general, health insurance companies consider the following illnesses and conditions to be pre existing conditions: Asthma and other chronic respiratory conditions. Diabetes. Arthritis.

A pre-existing condition can refer to the following: A past injury or illness that you have already recovered from (such as a broken ankle from your youth)

Pre-existing diseases or PED is a kind of chronic or long-term medical condition which already exists at the time when one buys a health insurance. The most common examples of pre-existing diseases are: High blood pressure.

Obesity is considered a pre-existing condition under the Affordable Care Act (ACA). So, as with all pre-existing conditions, insurance companies cannot make people with high BMIs pay more in premiums.