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? ›

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.

An illness or injury experienced before enrollment in a health insurance plan may be considered a pre-existing condition. Pre-existing conditions can include health issues such as cancer, diabetes, lupus, depression, acne, pregnancy, or just about any other health condition you can imagine.

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.

Is there health insurance for pre-existing conditions? Choosing a health plan is no longer based on the concept of a pre-existing condition. A health insurer cannot deny you coverage or raise rates for plans if you have a medical condition at the time of enrollment.

A few common examples of pre-existing conditions include high blood pressure, diabetes, cancer, and asthma. Previous injuries might be considered pre-existing conditions, depending on their severity and any lasting effects.

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.

Asthma is a chronic lung disease. Common symptoms are wheezing, coughing, chest tightness, and shortness of breath. During an asthma attack, the sides of the airways in lungs swell and the airways shrink, making it harder to breathe.

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) Symptoms which you have yet to seek medical advice, treatment or consultation (such as pains, lumps, bleeding etc.)

What are the most common pre-existing conditions? ›

Acne is one of the most common chronic pre-existing conditions and is the most common skin condition in the United States. At least 50 million people have acne, according to a 2006 national study of skin disease, the latest data available.

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.

The Affordable Care Act (ACA or “Obamacare”) prohibited pre-existing condition exclusions for all plans beginning January 2014, which was great news for all insurance beneficiaries with pre-existing conditions.

A pre-existing condition might be mild – for example, seasonal allergies or acne treated with simple medications. Or it could be more serious or require more costly treatment – such as diabetes, heart disease, or cancer.

The length of time before the start date of coverage during which a condition would be considered pre-existing varies, and can be anywhere from 30 days to 6 months or longer.

What is a "stability period" under the Patient Protection and Affordable Care Act (PPACA)? For the Patient Protection and Affordable Care Act (PPACA), the short answer is that a “stability period” is the period you are guaranteed coverage.

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.

According to Healthcare.gov, pregnancy is not considered a pre-existing condition. So if you were pregnant at the time that you applied for new health coverage: You can't be denied coverage due to your pregnancy. You can't be charged a higher premium because of your pregnancy.

/ˌpriː.ɪɡˈzɪs.tɪŋ/ existing before something else: The drug should be used with caution in patients with pre-existing cardiac disease.