What does pre-existing plans mean?
Asked by: Maurice Hahn | Last update: October 7, 2025Score: 4.4/5 (70 votes)
What is pre-existing in insurance?
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.
How long ago 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 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 long is something considered a pre-existing condition?
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.
Pre-existing conditions
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.
What does 12 months for pre-existing mean?
What does this mean for me? If your condition has been deemed as pre-existing by our medical practitioner, you'll need to serve the 12-month waiting period (or the remaining part of the period if you have served some of it with your previous fund) before you can claim for the service or treatment.
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.
What is the waiting period for preexisting conditions with Medicare?
Do Medicare Supplement insurance plans cover preexisting conditions? Yes. However, a Medigap insurance company can refuse to cover pre‑existing conditions for up to 6 months after enrollment. This is called a “pre‑existing condition waiting period.” After 6 months, the Medigap policy will cover those conditions.
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.
Can you get life insurance if you have a pre-existing condition?
Can people with pre-existing conditions qualify for life insurance? People with pre-existing conditions can still qualify for various life insurance policies. However, they may pay more in premiums because personal health history is a key factor that insurers use to calculate rates.
Is high cholesterol considered 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.
Do pre-existing conditions cost more?
Not if you're buying a Marketplace plan. These plans are not allowed to charge you more based on your health status or pre-existing condition.
Is existing and pre-existing the same?
Suppose you've had diabetes for three years, and you want to switch to another health insurance policy. Do you have an “existing condition” or a “pre-existing” condition? They're the same thing.
Is back pain a pre-existing condition?
For example, say you have chronic back pain from a past injury. If you get rear-ended in traffic and suffer a new back/neck injury, the insurance companies would likely classify the chronic back pain as a pre-existing condition.
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 the best secondary insurance if you have Medicare?
- Best for extra plan benefits: Humana.
- Best for straightforward coverage: State Farm.
- Best for extensive medical care coverage: AARP by UnitedHealthcare.
- Best for a range of Medigap plans: Blue Cross Blue Shield.
What is the 12 month waiting period for pre-existing conditions?
12-months Condition Specific Waiting Period – this is a period during which a member is not entitled to claim benefits in respect of a condition for which medical ad- vice, diagnosis, care or treatment was recommended or received within the 12 month period ending on the date on which an application for membership was ...
What is a waiting period for a pre-existing condition?
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.
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.
Does Medicare cover pre-existing conditions?
Medicare defines a pre-existing condition as any health problem that you had prior to the coverage start date for a new insurance plan. If you have Original Medicare or a Medicare Advantage plan, you are generally covered for all Medicare basics even if you have a pre-existing condition.
Will insurance cover something that happened before?
Insurance policies do not usually cover pre-existing damages. In fact, not only do they not cover them, but the insurance company can use previous damage to decline a future claim.
What counts as a pre-existing condition?
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. Most health insurance doesn't cover pre-existing or chronic conditions.
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.
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.