What is a pre-existing condition exclusion?
Asked by: Janae Nitzsche | Last update: November 12, 2025Score: 4.9/5 (62 votes)
What does pre-existing conditions exclusion period mean?
The time period during which an individual policy won't pay for care relating to a pre-existing condition. Under an individual policy, conditions may be excluded permanently (known as an "exclusionary rider").
What does pre-existing condition exclusion waiver mean?
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.
What is a pre-existing condition exclusion in an accident?
A pre-existing condition exclusion waiting period is the length of time after the start date of an insurance policy that a person must wait before any pre-existing conditions are covered. The waiting period is often longer for individually purchased policies.
Can insurance companies exclude 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 a Pre-existing Condition?
What counts as a pre-existing condition?
A pre-existing condition is typically when you have received treatment or diagnosis before you enrolled in a new health plan.
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 illnesses are considered pre-existing conditions?
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 exclusion mean in car insurance?
An excluded driver is a person in your household who has been explicitly excluded from coverage under your car insurance policy. Their name will show as "excluded" on your policy, and they won't be insured to drive any vehicles on your policy.
Can an insurer exclude coverage for a preexisting 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.
Does exclusion mean not covered?
An exclusion is a provision within an insurance policy that eliminates coverage for certain acts, property, types of damage or locations. Things that are excluded are not covered by the plan, and excluded costs don't count towards the plan's total out-of-pocket maximum.
Is high blood pressure a pre-existing condition for travel insurance?
Yes, high blood pressure is a pre-existing medical condition for travel insurance purposes. This means you must declare it when making an application for cover. Generally speaking, you should declare any condition that has been identified or is under investigation by a doctor.
What does a pre-existing condition limitation not apply?
Insurers in some states could have restrictions added on whether they can include a pre-existing condition exclusion period. Today, insurers cannot deny coverage to somebody based on pre-existing conditions, nor charge more.
What is an exclusion condition?
A diagnosis of exclusion or by exclusion (per exclusionem) is a diagnosis of a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from history, examination or testing.
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.
What is the pre-existing condition exclusion waiver?
A pre-existing condition waiver is a clause that removes any exclusions relating to pre-existing medical conditions, extending valuable travel protection to the policyholder in the event of a flare-up or related medical emergency.
What is exclusion and how does it work?
Exclusion is a form of bullying in the workplace that has adverse effects on victims' mental health. The typical scenario is a group of employees ignoring or not engaging with a particular employee. You'll commonly spot this behavior in shared areas like breakrooms.
Can my husband drive my car if he is not on my insurance?
Usually, yes. Your car insurance coverage should be able to extend to anyone else driving your car. Even if someone isn't listed on the policy, they can operate your vehicle. If you explicitly name someone as an excluded driver in your policy, however, none of this applies to them.
What is an exclusion in insurance?
Definition: Exclusions are the cases for which the insurance company does not provide coverage. These are the conditions excluded from the insured event to avoid losses to the company.
Can preexisting conditions be denied?
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 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 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.
Is high blood pressure a pre-existing condition?
Insurers generally define what constitutes a pre-existing condition. Some are obvious, like currently having heart disease or cancer. Others are less so – such has having asthma or high blood pressure.
What is included in pre-existing condition?
What Is a Preexisting Condition? A preexisting condition is a known illness, injury, or health condition that existed before someone enrolls in or begins receiving health or life insurance. This includes illnesses such as heart disease, diabetes, cancer, and asthma.
Is high cholesterol 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.