What is a pre-existing condition when applying for health insurance? — CoverMe Blog (2024)

FAQs

What is a pre-existing condition when applying for health insurance? — CoverMe Blog? ›

A preexisting condition is a health condition that existed prior to applying for health or life insurance. Conditions include illnesses such as diabetes, cancer, and heart disease. Under the Affordable Care Act (ACA), health insurance companies can't refuse coverage or charge more for preexisting conditions.

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts.

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.

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. They also can't charge women more than men.

Meaning, that as long as your condition and the treatment of that condition hasn't changed for 7 days before departure, your condition will be considered stable. Medical testing affects stability. If you've had medical tests and are awaiting results, that is considered not stable.

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.

Yes, high blood pressure counts as a pre-existing medical condition. If you're looking for travel insurance with a pre-existing medical condition, we define a pre-existing medical condition as an illness or injury that: has been identified by a doctor. is under investigation by a doctor.

A pre-existing medical condition is a disease, illness or injury for which you have received medication, advice or treatment or had any symptoms (whether the condition has been diagnosed or not) in the five years before your joining date. Health insurance doesn't usually cover 'pre-existing conditions'.

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

A pre-existing condition is a health issue that required diagnosis or treatment prior to an applicants' enrollment in a health plan.

What pre-existing conditions will not be covered? ›

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.

The concept of “guaranteed issue” in health insurance refers to the requirement that health insurance providers must offer coverage to any applicant, regardless of their health status, age, gender, or other factors. This means that individuals cannot be denied insurance coverage due to pre-existing conditions.

Are preexisting conditions covered? Yes. You cannot be denied coverage based on preexisting conditions.

A serious pre-existing condition is one that may require intensive medical intervention to treat or manage; or have high risk of future complications or recurrence, and therefore may require prolonged treatment.

The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

No. Marketplace health plans are not allowed to charge you more based on your health status or pre-existing condition. However, some plans, such as short-term policies, that are sold off the Marketplace might turn you down or charge you more based on your health status or pre-existing condition.

Your policy may delay coverage for pre- existing conditions for up to one year after your policy starts. This is called an “exclusion period.” This period is shorter if your previous insurance ended within the last two months.

You don't need to have had a diagnosis for your symptoms to be considered pre-existing by your insurer. You may have gone for tests, scans or other investigations before you had health insurance and only received a diagnosis later.

Pre-existing conditions are the medical issues themselves, while the acute onset of pre-existing conditions is the sudden and unexpected recurrence of a pre-existing condition.