What is an example of a pre-existing condition?

Asked by: Ivah Abernathy III  |  Last update: August 26, 2023
Score: 4.7/5 (25 votes)

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.

What counts as a preexisting condition?

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts.

What type of insurance can be denied due to pre-existing conditions?

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. They also can't charge women more than men.

How far back is a pre-existing condition?

Most insurers count any condition you have had symptoms or treatment for in the past five years as pre-existing, even if it was diagnosed more than five years ago. But some insurers include any conditions you have had treatment for during the past three years or seven years.

How long does pre-existing last?

The same goes for individual insurance purchased through a state or the federal health marketplace. Should a non-ACA-compliant plan still exclude pre-existing conditions, in most cases, it can only do so for a certain period—12 or 18 months, depending on when you enrolled.

What Is a Pre-existing Condition?

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Can life insurance deny you for pre-existing conditions?

Depending on the situation, a pre-existing health condition might cause an early or unexpected death, which increases the risk for the insurer. As a result, the cost of the policy is higher. If the risk is too high, the insurer may deny coverage altogether.

Is pre-existing the same as already existing?

If something's preexisting, it was already there — it existed earlier. 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 are 3 pre-existing conditions?

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 high blood pressure a pre-existing condition?

High blood pressure (also called hypertension) is a common pre-existing medical condition, and can be covered by your policy - but you need to meet the conditions below.

Does a condition need to be diagnosed to be pre-existing?

A pre-existing condition could be known to the person – for example, if she knows she is pregnant already. People might also apply for coverage when they unknowingly have an undiagnosed condition – for example, tumor cells might be growing within but won't be diagnosed until months or years later.

What are pre-existing conditions exclusions?

Pre-existing Condition Exclusion. A limitation or exclusion of benefits for a condition based on the fact that you had the condition before your enrollment date in the group health plan.

How do I appeal a pre-existing condition?

If you find yourself in this unfortunate situation, you need to speak with an experienced long-term disability lawyer right away. Your legal representative can help you understand why your claim was denied and take proactive and aggressive steps to file a timely administrative appeal if you have group coverage.

Which policy covers pre-existing diseases from day 1?

List of Health Insurance Plans Covering Pre-existing Diseases from Day 1
  • Aditya Birla Activ Health Platinum Essential Plan. ...
  • Aditya Birla Activ Health Platinum Enhanced Plan. ...
  • Star Diabetes Safe Insurance Plan. ...
  • Care Supreme Plan with Instant Cover. ...
  • Niva Bupa ReAssure 2.0 Plan with Smart Health+ ...
  • Universal Sompo A Plus Plan.

What medical conditions prevent you from getting life insurance?

Life insurance companies base their decisions to approve or deny coverage on risk. So, there is a chance that you may be denied life insurance if you have an illness like heart disease, cancer, diabetes, or HIV/AIDS. You may also be denied if you have a history of mental illness.

What is the purpose of pre-existing condition insurance plan?

The Affordable Care Act created the Pre-Existing Condition Insurance Plan (PCIP) to make health insurance available to those that have been denied coverage by private insurance companies because of a pre-existing condition. PCIP runs until 2014.

Does Medicare have a pre-existing condition clause?

Preexisting conditions, also known as previous health conditions, do not affect your Medicare eligibility and coverage. Original Medicare (Part A and Part B) is available to any individual age 65 or older, younger than 65 with a disability, or any age with end-stage kidney disease (ESKD).

What blood pressure is considered pre?

Prehypertension is defined as a systolic pressure from 120–139 millimeters of mercury (mm Hg) or a diastolic pressure from 80–89 mm Hg. Because blood pressure changes often, your health care provider will check it on several different days before deciding whether your blood pressure is too high.

Does high blood pressure make you uninsurable?

If you have high blood pressure, you may be wondering if you can still get life insurance. The answer is yes, but your rates may be higher than someone with normal blood pressure.

What is high blood pressure as a medical condition called?

High blood pressure (hypertension)

What does 12 months for pre-existing conditions mean?

What is the Waiting Period for Pre-Existing Conditions? Under the Private Health Insurance Act 2007, a health insurer may impose a 12 month waiting period on benefits for hospital treatment for pre-existing conditions.

What is a 3 6 pre-existing condition?

Example: A 3/6 pre-existing clause means that any disabling condition which the Insured received treatment during the 3 months immediately prior to the effective date of coverage is excluded. Once the Insured has been covered for 6 months the pre-existing clause no longer applies.

What is a 3 12 pre-existing condition?

Pre-Existing Condition Limitation 3/12 - A Pre-Existing Condition is a Sickness or Injury for which you have received treatment within 3 months prior to 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.

How does pre existing work?

Health insurance companies cannot refuse coverage 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 does pre existing mean dictionary?

preexisting. adjective. pre·​ex·​ist·​ing ˌprē-ig-ˈzi-stiŋ variants or pre-existing. : existing or present earlier or before a certain point of time.

Can you get life insurance if you're already sick?

The fortunate answer for many people is: Yes. It may be possible to get life insurance with these and other pre-existing conditions, including HIV infection. But details matter, and each answer will depend on your specific health situation.