Can preexisting conditions be denied?
Asked by: Kailee Renner | Last update: October 16, 2025Score: 4.1/5 (58 votes)
Can insurance decline preexisting conditions?
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.
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'.
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.
What does a pre-existing condition limitation not apply?
Insurers in some states could have restrictions added on whether they can include a pre-existing condition exclusion period. Today, insurers cannot deny coverage to somebody based on pre-existing conditions, nor charge more.
My claim was denied because of a pre-existing condition. What does this mean?
What are pre-existing conditions exclusions?
Pre-existing Condition Exclusion. A limitation or exclusion of benefits for a condition based on the fact that you had the condition before your enrollment date in the group health plan.
What is the waiting period for pre-existing disease?
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.
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.
Is high cholesterol a pre-existing condition?
Does high cholesterol count as a pre-existing medical condition? Yes. High cholesterol is considered a pre-existing medical condition by insurance companies, along with similar conditions like high blood pressure.
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.
How far back does pre-existing condition last?
A group health plan can count as pre-existing conditions only those conditions for which you actually received (or were recommended to receive) a diagnosis, treatment or medical advice within the 6 months immediately before you joined that plan. This period is known as the “look back” period.
What percentage of people have pre-existing conditions?
Introduction. According to a new analysis by the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition.
Is anxiety considered a pre-existing condition?
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.
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.
Is it a preexisting condition if you didn t know about it?
An illness or injury experienced before enrollment in a health insurance plan may be considered a pre-existing condition.
What pre-existing conditions are not covered?
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 are 2 harmful medical conditions associated with high cholesterol?
If you have high cholesterol, you have a higher risk of cardiovascular disease. That can include coronary heart disease, stroke, and peripheral vascular disease. High cholesterol has also been tied to diabetes and high blood pressure.
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.
Can an insurer exclude coverage for a pre-existing condition?
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.
Is acid reflux a pre-existing condition?
Reflux is often a side effect of medication that is prescribed to treat heart conditions such as atrial fibrillation or heart failure. Is reflux really a pre-existing medical condition? The simple answer is yes.
Is arthritis a pre-existing condition?
Examples of pre-existing conditions include: Chronic diseases (hypertension, heart disease, chronic obstructive pulmonary disease (COPD)) Mental health disorders (depression, anxiety, PTSD) Autoimmune diseases (rheumatoid arthritis, multiple sclerosis (MS), Crohn's disease)
How do I get insurance with a pre-existing condition?
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.
Is thyroid a pre-existing condition?
Pre-existing diseases list include high blood pressure, high BP, asthma, thyroid, diabetes, etc.
Is high blood pressure a pre-existing condition?
What is a preexisting condition? Preexisting conditions are health problems you had before applying for or enrolling in a new insurance plan. Some can be chronic diseases, such as diabetes, high blood pressure or cancer.