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.

What are pre-existing medical conditions? 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.

Under the Affordable Care Act, health insurance companies can't refuse to cover you 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.

Due to the added risk health problems create for insurers, some pre-existing conditions can raise your premium or even disqualify you entirely from certain types of life insurance. A few common examples of pre-existing conditions include high blood pressure, diabetes, cancer, and asthma.

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- ...

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.

Genetic information, without a diagnosis of a disease or a condition, cannot be treated as a pre-existing condition.

In the health insurance world, a pre-existing condition is any injury, sickness or condition that exists before the date an insurance policy takes effect. Examples include asthma, diabetes, anxiety, depression, high blood pressure, high cholesterol and so on.

Examples of Pre-existing Conditions

Arthritis. Cancer. Carpal tunnel syndrome. Depression.

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.

Before 2014, some insurance policies would not cover expenses due to pre-existing conditions. These exclusions by the insurance industry were meant to cope with adverse selection by potential customers. Such exclusions have been prohibited since January 1, 2014, by the Patient Protection and Affordable Care Act.

The ADA places restrictions on employers when it comes to asking job applicants to answer medical questions, take a medical exam, or identify a disability. An employer may not ask a job applicant, for example, if he or she has a disability (or about the nature of an obvious disability).

If your chronic condition is deemed to make you a higher risk insured, or make it likely your premium will be higher than someone without such a condition, you may wish to apply for a simplified issue policy which requires no medical exam, but does require an extensive health questionnaire.

Yes. When you sign up for Original Medicare, any preexisting condition will be covered immediately. However, you'll still be responsible for all out-of-pocket expenses like deductibles, copayments and coinsurance.

A pre-existing condition is a medical issue you've experienced in the past. This includes chronic conditions like diabetes or asthma, and one-off symptoms like knee pain. With us, a pre-existing condition is when you've had symptoms, medication, advice, treatment, or tests for something before taking out health cover.

Breathing conditions like asthma. Circulatory conditions such as strokes or high blood pressure. Gastrointestinal or digestive tract problems. Bone or joint conditions. Any form or type of cancer.

Some of the more common pre-existing conditions include asthma, arthritis, orthopedic problems, muscle strains or tears, and injuries suffered in past automobile accidents.