How do you know if you have a pre-existing condition?

Asked by: Annamae Witting  |  Last update: December 25, 2022
Score: 5/5 (67 votes)

A pre-existing condition is a health problem you had before the date that your new health coverage starts. Epilepsy, cancer, diabetes, lupus, sleep apnea, and pregnancy are all examples of pre-existing conditions.

How do you determine 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, COPD, cancer, and sleep apnea, may be examples of pre-existing health conditions. They tend to be chronic or long-term.

What happens if you have 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. They also can't charge women more than men.

How does insurance know about 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.

What pre-existing conditions will be covered?

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. They cannot limit benefits for that condition either.

What is a Pre existing Condition ?

40 related questions found

What is the difference between existing and pre-existing?

A. You can use pre- in ways that are redundant, but it's a valid prefix, and preexisting has its own meaning. For instance, if you want to describe dinosaurs in relation to humans, existing doesn't work, but preexisting does.

How long is pre-existing?

A pre-existing condition is defined as any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness, ailment or condition existed at any time in the period of 6 months ending on the day on which the person became insured under the ...

Is depression considered a pre-existing condition?

In health insurance terms, depression is a pre-existing condition if you have seen a provider for it or been diagnosed with it during a specified period of time before you sign up for a new health plan.

Is arthritis a pre-existing condition?

Arthritis is generally considered pre-existing medical condition. This doesn't necessarily mean you can't get travel insurance, but you do need to disclose your condition before you book your cover. With arthritis, you'll need to declare your specific type of arthritis whether it's osteo, rheumatoid, or psoriatic.

Is High Cholesterol a pre-existing condition?

High cholesterol as diagnosed by a physician is considered to be a pre-existing condition by most - if not all - travel insurers.

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 is existing condition?

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.

What does it mean by pre-existing?

Definition of preexisting

: existing at an earlier time a preexisting medical condition.

Which diseases are not covered in health insurance?

List of Diseases Not Covered Under Health Insurance
  • Congenital Diseases/Genetic Disordered. ...
  • Cosmetic Surgery. ...
  • Health issues due to consumption of drugs, alcohol, and smoking. ...
  • IVF and Infertility Treatments. ...
  • Pregnancy Treatment. ...
  • Voluntary Abortion. ...
  • Pre-existing Illnesses. ...
  • Self-Inflicted injury.

Is knee pain a pre-existing condition?

Any conditions, whether it be an illness or injury, that you had prior to the workplace accident is considered a pre-existing medical condition. Some obvious examples of pre-existing injuries include herniated disks, broken bones, shoulder or upper body injuries, knee injuries, and torn ligaments.

Can I get private health insurance with a pre-existing condition?

You can still get health insurance cover if you have pre-existing medical conditions, but it is unlikely your policy will provide cover for them. The type of underwriting of your health plan determines whether your pre-existing conditions will be covered in the future.

Is anxiety considered a pre-existing condition?

Not only do insurers have to offer coverage to people with common pre-existing conditions, like depression or anxiety, plans also have to cover treatment.

Can you get life insurance if you have anxiety?

Anxiety is a common medical condition, but it can affect your life insurance rates or even your ability to get a life insurance policy. While it's still possible to get covered — especially if your anxiety is well-controlled — you may be forced to pay higher premiums for coverage.

What depression does to the human body?

Physical symptoms are common in depression, and, in fact, vague aches and pain are often the presenting symptoms of depression. These symptoms include chronic joint pain, limb pain, back pain, gastrointestinal problems, tiredness, sleep disturbances, psychomotor activity changes, and appetite changes.

Can I buy insurance after diagnosis?

Here are some health insurance situations people often wonder about: If you have a pre-existing condition (a health problem you had before a new health care plan coverage starts), such as cancer or other chronic illness, health insurance companies can't refuse to cover you.

What's another word for pre existing?

Pre-existing synonyms

Existing previously. Already in existence before (something else).

What is a 3/12 pre-existing condition?

* Coverage is written with a 3/12 pre-existing condition clause. This means that if an insured was treated for a medical condition 3 months prior to their effective date, it will not be covered unless the insured has been insured and still actively at work for 12 months.

What is the difference between pre-existing conditions and exclusions?

What Is the Pre-existing Condition Exclusion Period? The pre-existing condition exclusion period is a health insurance provision that limits or excludes benefits for a period of time. The determination is based on the policyholder having a medical condition prior to enrolling in a health plan.