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Which Health Insurance Covers Pre-Existing Conditions

Medical illness or injury that you have before you start a new health care plan may be regarded as a “pre-existing condition.” Examples of pre-existing health conditions include diabetes, COPD, cancer, and sleep apnea. They tend to be chronic or long-term.

How to Determine Pre-Existing Conditions

A pre-existing condition is one for which you have received treatment or diagnosis before enrolling in a plan.

A pre-existing condition is usually one for which you have received treatment or diagnosis before enrolling in a new health insurance plan. Before 2010 and the passage of the Affordable Care Act (ACA), an insurance company would review your enrollment application. If they established, you had a pre-existing condition, could deny you coverage, or provide coverage at inflated rates.

The Affordable Care Act made it illegal for health insurance companies to deny you medical coverage or raise rates because of a pre-existing condition.

Examples of Pre-Existing Health Conditions

Chronic illnesses, medical conditions, and many forms of cancer, diabetes, lupus, epilepsy, and depression may be regarded as pre-existing conditions. Pregnancy before enrollment is also regarded as pre-existing and chronic, though less severe conditions like acne, asthma, anxiety, and sleep apnea may also qualify.

Can I Be Denied Health Insurance in Case I Have A Pre-Existing Condition?

If you are enrolled in a plan from 2010, then no, your insurer cannot legally deny you coverage or charge you higher premiums since you have a pre-existing condition.

The Affordable Care Act, passed in 2010, made it illegal for health insurance carriers to deny you coverage or charge high rates for pre-existing conditions. Moreover, if your health changes and you develop a chronic medical condition while enrolled in a health plan, your insurance carrier can’t raise your rates because of that medical condition. Nevertheless, annual premium increases may apply to your plan for other reasons.

If, however, you are enrolled in health insurance that started before 2010, you have a “grandfathered plan.” These plans can cancel your coverage or can charge you higher rates because of a pre-existing condition.

If you are exploring coverage choices, it is important to be aware of any potential changes to healthcare law that could affect how pre-existing conditions are covered.

Is Pregnancy Considered a Pre-Existing Condition?

No. If you get pregnant before enrolling in a health insurance plan, you cannot be denied coverage or charged more because of pregnancy. Coverage for pregnancy and delivery starts from the day you enroll in a plan.

Health Insurance for Pre-Existing Conditions

Choosing a plan is no longer based on the concept of a pre-existing condition.

Selecting a health plan is no longer based on the concept of a pre-existing condition. A health insurer can’t deny you coverage or raise rates for health insurance plans if you have a medical condition at the time of enrollment. Nevertheless, there may be health plans that are a better fit for you than others if you have a chronic or pre-existing medical condition.

For instance, if you need regular medical care, surgeries, or treatments, then a plan with a little higher monthly premium and lower deductible may offer you the coverage you need and help you manage more predictable costs.

Could My Health Insurance Plan Have a Pre-Existing Condition Waiting Period?

No. There is no waiting time for medical plans, as well as for pre-existing conditions.

When selecting a health plan, consider your medical requirements. If you have a chronic or ongoing medical condition that needs more frequent care, those needs could affect the type of plan you choose, but you cannot be denied coverage or charged more because of a pre-existing condition.

References and Resources

• The Affordable Care Act of 2010
• Pre-Existing Conditions