Can I be denied insurance for a pre-existing condition?
Asked by: Sarah Witting | Last update: December 13, 2025Score: 4.2/5 (37 votes)
What type of insurance can be denied due to pre-existing conditions?
Coverage for pre-existing conditions
All Marketplace plans must cover treatment for pre-existing medical conditions. No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.
Can insurance decline preexisting conditions?
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.
What pre-existing conditions are not covered by life insurance?
- Anxiety and depression.
- Asthma.
- Diabetes.
- Heart disease.
- High blood pressure.
- High cholesterol.
- HIV.
- Obesity.
How does insurance check for pre-existing conditions?
To determine if a condition is pre-existing, insurers examine medical history, treatment records, and diagnosis reports. They may use “look-back periods,” which are specific timeframes—typically six months to a year before coverage begins—to review medical history.
Can Insurance Deny Coverage for Pre-Existing Condition? - CreditGuide360.com
What is the waiting period for pre-existing diseases?
Almost all health insurance plans cover pre-existing diseases after a waiting period of usually 2 to 3 years. This implies that any hospitalization expenses related to the declared ailments can be claimed only after 2 to 3 successful years with the insurer.
How far back is a pre-existing condition?
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'.
What illnesses are considered 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.
Can a health insurance company refuse to insure you?
Insurers cannot refuse to pay for essential health benefits for any pre-existing conditions. Additionally, once you are enrolled, the plan cannot deny you coverage or raise your rates based solely on your health.
What disqualifies someone from getting life insurance?
They can include engaging in risky hobbies and behaviors like skydiving; having a history of DUIs or speeding tickets; having a dangerous job like roofing; having a criminal record or a less than ideal financial history; being a smoker; and failing a drug test.
Can I be denied health insurance because of a pre-existing condition reddit?
It's been over a decade. Obamacare got rid of the pre-existing conditions and a bunch of other things. It also created a marketplace where people who don't get insurance through their employer can buy insurance that meets the requirements of the law (we say that it's ACA-compliant).
Will my new insurance cover an old medical bill?
Conclusion: Will My Insurance Cover an Old Medical Bill? Your insurance will only cover an old medical bill if that insurance was in effect on the date medical services were provided. If you did not have health insurance in effect on the date of service, any new insurance won't pay for that old medical bill.
How many Americans have pre-existing conditions?
A pre-existing condition is a health diagnosis that exists before someone tries to enroll in a new health insurance policy. Previous research estimated that nearly 27% of US adults aged 18 to 64 years had a declinable (ie, pre-existing) condition.
Do any insurers cover pre-existing conditions?
In some cases, you'll also need to give the insurer access to your medical records. The insurer can then decide if they want to insure you or not for a pre-existing condition. So, you may be able to get insurance for a pre-existing medical condition that is excluded with Moratorium underwriting.
Can I buy health insurance and use it immediately?
Many, but not all, short term health insurance plans can take effect the day after your application is received.
Can you get an advantage plan with pre-existing conditions?
You can join a Medicare Advantage Plan even if you have a pre-existing condition. What if I have End-Stage Renal Disease (ESRD)? You can join a Medicare Advantage Plan even if you have ESRD. In many Medicare Advantage Plans, you can only use health care providers who are in the plan's network and service area.
Can preexisting conditions be denied?
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.
How do insurance companies know if you have a pre-existing condition?
Insurers then use your permission to snoop through old records to look for anything that they might be able to use against you. If you have a pre-existing condition, they'll try to deny your claim on the grounds that you were already injured and their insured had nothing to do with it.
Which health insurance denies the most claims?
According to the analysis, AvMed and UnitedHealthcare tied for the highest denial rate, with both companies denying about a third of in-network claims for plans sold on the Marketplace in 2023, respectively.
How long is a condition considered pre-existing?
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.
Can UnitedHealthcare deny coverage for preexisting conditions?
Summary. Pre-existing condition exclusions are no longer applied to members covered under health insurance policies and group health plans. These rules apply equally to collectively bargained and non-collectively bargained plans.
Is GERD a pre-existing condition?
It may, as GERD is considered a pre-existing condition and could potentially lead to higher premiums or difficulty finding coverage. However, each insurance company has their own underwriting guidelines and some may not consider GERD to be a significant risk factor.
Why doesn't insurance cover pre-existing 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.
How much is health insurance with pre-existing conditions?
Not if you're buying a Marketplace plan. These plans are not allowed to charge you more based on your health status or pre-existing condition.
What is the exclusion period for pre-existing conditions?
A pre-existing condition exclusion can not be longer than 12 months from your enrollment date (18 months for a late enrollee).