Is there any policy for pre-existing conditions?

Asked by: Helga Price II  |  Last update: March 11, 2025
Score: 4.8/5 (52 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.

Can I be denied health insurance because of 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. They cannot limit benefits for that condition either.

What is the medicare rule for preexisting conditions?

Does Original Medicare cover preexisting conditions? Yes. When you sign up for Original Medicare, any preexisting condition will be covered immediately. You'll still be responsible for all out-of-pocket expenses like deductibles, copayments and coinsurance.

How do insurance companies handle pre-existing conditions?

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.

What is the exclusion for pre-existing conditions?

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 You Get A Life Insurance Policy With Pre-Existing Conditions?

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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.

How far back do insurance companies look 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.

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.

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.

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 is the usual minimum waiting period for a pre-existing condition?

The length of time before the start date of coverage during which a condition would be considered pre-existing varies, and can be anywhere from 30 days to 6 months or longer.

What is the 2 2 2 rule in Medicare?

Introduced in the Fiscal Year 2014 Inpatient Prospective Payment System (IPPS) Final Rule, the two-midnight rule specifies that Medicare will pay for inpatient hospital admissions when a physician reasonably expects the patient's care to require a stay that crosses two midnights, and the medical record supports this ...

What two medical conditions may be eligible for Medicare coverage?

Medicare is a federal health insurance program for people age 65 or older. People younger than age 65 with certain disabilities, permanent kidney failure, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease), may also be eligible for Medicare.

What is the waiting period for pre-existing diseases?

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.

Does Blue Cross Blue Shield cover past medical bills?

Health insurance policies are designed to cover medical expenses incurred during the period when the policy is active. This means that if you received medical services before your policy's effective date, those expenses are generally not covered.

Can Medicare deny coverage for preexisting conditions?

While Original Medicare doesn't restrict coverage based on pre-existing conditions, the rules are different for Medicare Supplement insurance plans. In some cases, insurance companies can review your medical history and charge you more, impose a waiting period for coverage, or deny your application altogether.

What is considered a pre-existing condition for health insurance?

Any condition (either physical or mental) including a disability for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on your enrollment date in a health insurance plan.

Will medical cover previous bills?

Retroactive Medi-Cal covers unpaid medical expenses from the three months prior to the month you apply for Medi-Cal. If you have unpaid bills from the three previous months, enter that information during the application process. If you qualify for Medi-Cal, you will also be evaluated for retroactive coverage.

Can I throw away old medical bills?

Yes. After you've paid your bill, you can pretty much shred these unless they contain tax-deductible expenses. In that case, you'll need to keep them with your “tax stuff.”

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.

What pre-existing conditions are not covered by life insurance?

What medical conditions prevent you from getting life insurance?
  • Anxiety and depression.
  • Asthma.
  • Diabetes.
  • Heart disease.
  • High blood pressure.
  • High cholesterol.
  • HIV.
  • Obesity.

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.

What is a waiting period for a pre-existing condition?

A pre-existing condition exclusion period is a window of time, after a health plan takes effect, when a pre-existing condition (or multiple pre-existing conditions) will not be covered by the plan.

Can insurance see medical records?

The answer varies depending on the state. In California, the retention period can be anywhere from two to ten years, depending on the type of procedure or healthcare provider. However, an insurance claim medical report should only look as far back as the injury in question.

What is a pre-existing condition exclusion waiver?

What is the Waiver of Pre-Existing Medical Conditions in Travel Insurance? Simply put, the Waiver of Pre-Existing Medical Conditions covers, or “waives” the companies right to exclude pre-existing medical conditions from their policy.