Is ADHD considered a pre-existing condition?
Asked by: Stuart Heaney | Last update: September 28, 2025Score: 4.7/5 (21 votes)
Is ADHD a pre-existing condition health insurance?
Currently, health insurers cannot deny health insurance coverage or charge higher premiums based on having a “pre-existing condition” like ADHD diagnosed before an individual buys health insurance.
What is considered a pre-existing condition?
A “pre-existing condition” is a health condition that exists before someone applies for or enrolls in a new health insurance policy. Insurers generally define what constitutes a pre-existing condition. Some are obvious, like currently having heart disease or cancer.
What counts as a pre-existing medical condition?
You may have gone for tests, scans or other investigations before you had health insurance and only received a diagnosis later. It applies to any medical condition that you saw your doctor about the five years before the start date on your health insurance.
How do you know if a condition 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 ...
Health Care Crisis: Pre-existing conditions
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 are pre-existing illnesses?
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.
Is mental health a pre-existing condition?
You will need to purchase a plan that offers coverage for mental health and substance use, or behavioral health to have coverage for depression that's pre-existing. Health plans you get through your employer that come from major health insurance carriers will also typically consider depression a pre-existing condition.
How do insurance companies know if you have a pre-existing condition?
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 preexisting conditions be denied?
Coverage for pre-existing 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. Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health.
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.
Is autism a pre-existing condition?
While it was once possible that you could be denied or lose your coverage because of an ASD diagnosis, it is no longer the case. ASD is considered a pre-existing condition. A pre-existing condition is a medical condition that existed before someone applies for or enrolls in a new health insurance policy.
Are allergies a pre-existing condition?
A pre-existing condition can be something as common as high blood pressure or allergies, or as serious as cancer, type 2 diabetes, or asthma—chronic health problems that affect a large portion of the population.
Does having ADHD affect insurance?
When looking into life insurance for someone living with ADHD, you may be able to find a policy that is offered at standard terms. This means that there will likely not be any exclusions or any premium increases. This does depend on any medication or treatments that you are currently taking and/or undergoing.
Will my insurance cover done ADHD?
Yes, ADHD treatment is typically covered by insurance, depending on your plan. Most health plans cover both diagnosing and treating ADHD in children and adults. Some insurance companies require a referral from a primary care physician before covering any mental health services for ADHD.
What pre-existing conditions are not covered in insurance?
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 are my pre-existing conditions?
A pre-existing condition is any condition you had before your policy started. A chronic condition is something that is on-going and that has no known cure. Asthma, arthritis and diabetes are examples of chronic conditions.
What is defined as a pre-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.
Is anxiety a pre-existing medical condition?
A pre-existing medical condition is any condition you have at the time you apply for insurance. Many insurance policies do not cover pre-existing conditions. This means that they will not pay out on a claim related to a pre-existing condition, including mental health problems.
Why is mental health not covered by insurance?
The parity law does not require insurers to provide mental health benefits—rather, the law states that if mental health benefits are offered, they can't have more restrictive requirements than those that apply to physical health benefits.
Does ADHD affect travel insurance?
ADHD is covered as a standard.
There are no health questions for ADHD to answer as long as: You have not cancelled or curtailed a trip in the last five years due to ADHD.
What are the most common pre-existing conditions?
Acne is one of the most common chronic pre-existing conditions and is the most common skin condition in the United States. At least 50 million people have acne, according to a 2006 national study of skin disease, the latest data available.
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.
What is a pre-existing condition for disability?
A pre-existing condition means a sickness or injury for which you have received treatment within 12 months before your effective date. Any disability contributed to or caused by a pre-existing condition within the first 12 months of your effective date will not be covered.