Can insurers ask about preexisting conditions?

Asked by: Ms. Lilyan Baumbach Sr.  |  Last update: August 4, 2023
Score: 4.2/5 (27 votes)

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.

Can you be denied coverage for a pre-existing 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.

Do you have to declare pre-existing conditions?

Clinical Nurse Specialist, Kay Greveson, explains: “A pre-existing medical condition can be affected by changes in temperature and climate and should always be declared, even if it is being controlled by medication.”

How does insurance determine pre-existing condition?

How are pre-existing conditions determined? A pre-existing condition is typically one for which you have received treatment or diagnosis before you enrolled in a new health plan.

Can insurance companies ask health questions?

Under health reform, health insurance companies can't make you answer health questions to buy health insurance. They also can't require a pre-existing condition waiting period for claims you submit.

35 related questions found

Can insurance companies check your medical history?

Insurers can't see your medical records unless you give them written permission. Find out why insurers might need to access your medical history and what information they'd get.

Can insurance companies have access to protected health information?

General Right. The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more “designated record sets” maintained by or for the covered entity.

Is high blood pressure considered a pre-existing condition?

High blood pressure (also called hypertension) is a common pre-existing medical condition, and can be covered by your policy - but you need to meet the conditions below.

Is high blood pressure considered a preexisting condition for travel insurance?

The quick answer to this question is: yes! You should always tell your insurer about your high blood pressure, even if it's being well-managed through medication. High blood pressure is considered to be a 'pre-existing medical condition' by insurers.

Whats classed as a pre-existing condition?

As defined most simply, a pre-existing condition is any health condition that a person has prior to enrolling in health coverage. A pre-existing condition could be known to the person – for example, if she knows she is pregnant already.

Can insurance companies deny you?

A car insurance company can deny coverage for almost any reason. An insurer might deny coverage to a driver who it believes poses a higher risk and is more likely to file a claim. Additionally, each state may have different criteria for why an insurance carrier is allowed to deny coverage.

What is waiting period for pre-existing medical conditions?

Types of Waiting Period in Health Insurance

Almost all health insurance plans cover pre-existing diseases after a waiting period of usually 2 to 4 years. This implies that any hospitalization expenses related to the declared ailments can be claimed only after 4 successful years with the insurer.

What happens if you don't declare medical conditions for travel insurance?

If you don't disclose you're pre-existing medical conditions your Travel Insurance policy may become invalid. This could result in you having to pay extensive medical bills should the worse happen. If your policy is invalid – you'll have to personally pay the costs for: Medical treatment.

What information do insurance companies have access to?

Insurance companies will ask for personal information such as your Social Security number and birth date to confirm your identity. They may also want to know what your salary is because they might limit how much insurance you can get based on your annual earnings.

Do insurance companies have a duty of confidentiality?

Under the privacy rule, the federal regulation implementing HIPAA, individuals have the right to request that insurers keep communications about their health care confidential. For a married person, this includes a request that information not be provided to spouse.

How far back do insurance companies check medical records?

How far back do life insurance companies look at medical records? A life insurance medical records request usually focuses on the past five to ten years. The insurer wants to find out if you recently had illnesses or treatments. They'll also want to know if you've been clear of any illnesses for a couple of years.

Do you have to tell life insurance about new medical conditions?

The simple answer is no, you don't need to inform your life insurance provider of any health issues that have arisen since you took the policy out. The application is underwritten at the time you took out the policy and based on your health at that time.

Where do insurance companies get their data?

Property and casualty insurance companies are collecting data from telematics, agent interactions, customer interactions, smart homes, and even social media to better understand and manage their relationships, claims, and underwriting.

Do insurers share information?

Although insurers share information they would be unlikely to compare notes on the contents of an application form - although they do share information on claims and instances of policies being cancelled or voided, or insurance being declined.

Do I need to declare anxiety on travel insurance?

Yes. You will need to declare anxiety if you have ever received treatment for anxiety.

Which medical conditions affect travel insurance?

Medical conditions you need to declare for travel insurance quotes include respiratory conditions, heart, liver, kidney, brain or circulatory disease or damage, diabetes, strokes or central nervous system disorders and terminal illnesses.

Which insurance is best for pre-existing medical conditions?

Best Health Insurance Plans For Pre-Existing Diseases To Buy In...
  • Apollo Munich Energy Health Insurance Plan.
  • Aditya Birla Activ Health Enhanced Plan.
  • HDFC ERGO Energy Gold Health Insurance Plan.
  • Star Health Diabetes Safe Health Insurance Plan.

Why do insurance companies have waiting periods?

A term typically seen in maternity and a handful other insurance policies, 'waiting period' is a source of confusion for many. It protects insurers from clients who know full well that they have a medical cost coming up and file for claims immediately after their plan enrollment.

Why would an insurance company not insure you?

Car insurance companies are more likely to deny insurance to people they believe are more likely to file a claim. Insurance companies frequently deny coverage if the applicant has a recent history of accidents, a series of minor traffic tickets or a serious infraction such as a DUI.