What is a pre-existing condition in regards to LTC policies a condition that a person has received treatment or advice?
Asked by: Mr. Jerrold Legros | Last update: January 2, 2026Score: 4.3/5 (20 votes)
What is a pre-existing condition under a long-term care insurance policy?
A Pre-Existing Condition means a condition (illness, disease, injury or symptom) for which medical advice or treatment was recommended by, or received from, a Health Care Professional within six (6) months prior to Your initial Certificate Effective Date.
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 is the definition of pre-existing condition in a long-term care policy Quizlet?
What is the definition of pre-existing condition in a long-term care policy? A) a condition for which advice or treatment was received within 6 months before the effective date of coverage.
What is considered a pre-existing condition for travel insurance?
Generally, an example of a pre-existing condition is something you may have had for much of your life, such as diabetes or asthma. Or it may be a more recently diagnosed condition, such as your knee that started hurting a few days before your trip.
What is a Pre existing Condition ?
What is classed as a pre-existing medical condition?
For the purposes of your life insurance cover, a pre-existing medical condition is any illness or injury that exists before, or at the time, you take out a life insurance policy.
What pre-existing conditions are not covered by life insurance?
- Anxiety and depression.
- Asthma.
- Diabetes.
- Heart disease.
- High blood pressure.
- High cholesterol.
- HIV.
- Obesity.
What do you call pre-existing conditions?
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 ...
What is a preexisting condition quizlet?
HIPAA has defined pre-existing conditions to be health issues that have existed, treated of diagnosed within the last 6 months prior to employment.
What is the least expensive type of long-term care?
- Home healthcare: This includes home health aides and any other long-term care support you receive at home.
- Assisted living communities: This type of long-term care provides housing with round-the-clock staff to help with basic daily living activities.
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'.
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.
Are blood clots a preexisting condition?
Certain people are genetically disposed to blood clots, putting them at higher risk of a pulmonary embolism, so a family history can help your doctor identify the issue. Additionally, preexisting conditions like heart disease, interstitial lung disease, COVID-19, or many forms of cancers can make clotting more likely.
What is 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.
When can a long-term care policy deny a claim?
Long term care insurance claims are exacting and demanding. Claims will be denied if the type of care doesn't match the policy's definition of covered care. AND Claims are regularly denied if your medical paperwork doesn't match the specific policy triggers in your policy.
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.
Which of the following would be considered a pre-existing condition?
What are some examples of pre-existing health conditions? Chronic illnesses and medical conditions, including many forms of cancer, diabetes, lupus, epilepsy, and depression may be considered pre-existing conditions. Pregnancy before enrollment is also considered pre-existing and chronic.
What is an example of preexisting?
Someone might offer you a babysitting job, but if you have a preexisting agreement to watch your little brother that night, you'll have to turn it down.
What is an unknown pre-existing condition?
What Is a Pre-existing Condition? Generally, pre-existing health conditions include all such medical or physical conditions that an individual had before the start date of their insurance policy, including high blood pressure, diabetes, AIDS, pregnancy, and any such condition, whether known or unknown.
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 difference between existing and pre-existing?
Existing is a certain thing that is present nowadays and can be seen in present time. Preexisting refers to something that has existed a long time ago, and forgotten, and has existed once more in our present time.
Is mental illness considered 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.
What conditions make you uninsurable for life insurance?
Due to the added risk health problems create for insurers, some pre-existing conditions can raise your premium or even disqualify you entirely from certain types of life insurance. A few common examples of pre-existing conditions include high blood pressure, diabetes, cancer, and asthma.
What is an acute onset of a preexisting condition?
An "Acute Onset of a Pre-Existing Condition" is a sudden and unexpected outbreak or recurrence of a Pre-Existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires immediate care.
Is obesity a pre-existing condition?
Declinable Pre-existing Conditions
Insurers maintained lists of health conditions for which applicants would routinely be denied coverage. Declinable conditions included AIDS/HIV, congestive heart failure, diabetes, epilepsy, severe obesity, pregnancy, and severe mental disorders.