Can you be denied insurance for pre-existing condition?

Asked by: Dr. Carmella Hickle  |  Last update: September 6, 2023
Score: 4.6/5 (46 votes)

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.

What does insurance consider a pre-existing condition?

A medical illness or injury that you have before you start a new health care plan may be considered a pre-existing condition. Conditions like diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea, may be examples of pre-existing health conditions. They tend to be chronic or long-term.

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.

Does Canadian healthcare cover pre-existing conditions?

Many Canadians have some kind of pre-existing condition, such as diabetes, asthma or other manageable conditions that don't have a debilitating impact on their daily lives. Insurance is certainly available for anyone with this kind of condition.

Can you get life insurance if you have a pre-existing condition?

Pre-existing conditions can make it more difficult and expensive to get life insurance, but even if you have a chronic or terminal health problem, you can likely find a policy you qualify for if you shop around.

Should Insurance Charge You for Your Pre-Existing Condition? | NBC News

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What illnesses prevent you from getting life insurance?

Life insurance companies base their decisions to approve or deny coverage on risk. So, there is a chance that you may be denied life insurance if you have an illness like heart disease, cancer, diabetes, or HIV/AIDS. You may also be denied if you have a history of mental illness.

Why would I get denied for life insurance?

Why would a life insurance application be denied? A life insurance application may be denied if you have high-risk medical conditions, dangerous hobbies, or if you left important information off your application. You may also be ineligible for certain policies due to advanced age.

How do I get cover for pre-existing conditions?

Full medical underwriting

When you apply for cover, you'll need to fill in a questionnaire about your medical history. Your insurer might also need to speak to your doctor. Once they've gathered all the information, they'll decide what symptoms and conditions they can or can't cover and let you know.

What is a pre-existing medical condition Canada?

Typically, a pre-existing condition is a medical illness or injury that was diagnosed or treated prior to leaving your Province or Territory of residence.

What is a pre-existing condition in Canada?

Generally speaking, a pre-existing condition is defined as any illness, injury or medical condition, whether or not diagnosed by a doctor, for which you've had advice, treatment or experienced symptoms, prior to the effective date of your policy.

What is the time limit for pre-existing conditions?

The same goes for individual insurance purchased through a state or the federal health marketplace. Should a non-ACA-compliant plan still exclude pre-existing conditions, in most cases, it can only do so for a certain period—12 or 18 months, depending on when you enrolled.

What is the waiting period for pre-existing disease?

Pre-Existing Diseases (PED) Waiting Period

Generally, the waiting period for pre-existing disease in health insurance plans is 1-4 years. However, the pre-existing disease waiting period varies with the health condition of the insured as well as the health insurance plan they choose.

What is 12 month pre-existing condition exclusion?

The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

Can insurance companies deny coverage?

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.

Is high blood pressure 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.

What is the longest period of time an insurer may exclude coverage for pre-existing conditions in an LTC policy?

Policies covering long term care services may not contain a preexisting condition limitation of more than six months after the effective date of coverage.

Is a pre-existing condition a diagnosis?

A pre-existing condition is a health issue that required diagnosis or treatment prior to an applicants' enrollment in a health plan.

What is an unstable medical condition?

Medically unstable means a recent acute illness or complications of a chronic condition that are not physically or mentally controlled by diet, medication, or physical exercise and which require frequent monitoring and testing by skilled professionals.

Is a broken bone a pre-existing condition?

Pre-existing conditions can include serious illnesses, such as cancer. It can also include less serious conditions, such as a broken leg, and in some cases, even prescription drugs can count as a pre-existing condition.

Is migraine a pre-existing condition?

Normally insurers will consider migraines to be a pre-existing condition but whether this makes a difference to your policy depends on whether there is anything more serious causing your migraines. Again, it will be the underlying cause that makes a difference in these cases.

Is arthritis a pre-existing condition?

Rheumatoid Arthritis (RA) is a pre-existing medical condition defined as a chronic inflammatory disorder whereby one's own immune system actively attacks one's own tissues.

Is menopause a pre-existing condition for travel insurance?

But menopause itself isn't one of them because it's not a disease, it's a normal stage of life for women. "Just being a 50-year-old woman with no symptoms obviously would not be a problem," says Mark Brown, a certified financial planner and longtime insurance agent in Naperville, Ill.

Which cases is likely to be declined by a life insurer?

These are the nine most common reasons why you're not approved for a life insurance policy.
  • Medical issues. The list below is not exhaustive. ...
  • Hazardous occupation. Not everyone works a low-risk desk job. ...
  • Financial reasons. ...
  • Lifestyle choices. ...
  • Lab results. ...
  • Driving record. ...
  • Criminal record. ...
  • Foreign travel.

Can you reapply for life insurance after being denied?

Even if you had a life insurance application denied in the past, it doesn't automatically disqualify you from purchasing coverage in the future. However, it may take some additional work on your behalf to present yourself as a better applicant.

Can you be denied life insurance in Canada?

Life insurance companies are businesses, so, it is actually very common for life insurance companies to deny your application if they think you are too risky to insure. If you are applying for traditional life insurance, the most common reason for being denied is if you have any underlying health conditions.