What is considered pre-existing condition insurance?

Asked by: Mr. Darian Lebsack Sr.  |  Last update: October 5, 2023
Score: 4.3/5 (61 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 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.

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.

Is high blood pressure considered 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.

Is a torn ACL a pre-existing condition?

Torn cruciate ligaments are considered a chronic pre-existing condition due to the high rate of other cruciate ligaments tearing during a pet's lifetime. Dogs are at a significantly higher risk of having a torn cruciate ligament than cats.

Should Insurance Charge You for Your Pre-Existing Condition? | NBC News

26 related questions found

What is pre-existing condition examples?

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.

Is knee pain considered pre-existing condition?

Pre-existing medical conditions are injuries or illnesses that predate a workplace accident (and were not in turn related to workplace activity). Pre-existing conditions can be obvious existing injuries such as herniated discs, broken bones, torn ligaments, knee injuries, back injuries, neck injuries, etc.

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 illnesses affect 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 do insurance companies consider high blood pressure?

Life insurance companies typically consider high blood pressure as a systolic reading over 135 and a diastolic reading over 85. Some companies consider high blood pressure a systolic reading over 130 and a diastolic reading over 80 — it will depend on the specific insurer.

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.

What is the waiting period for pre-existing disease?

Pre-Existing Diseases (PED) Waiting Period

Generally, the waiting period for pre-existing disease in health insurance plans is 1-4 years. However, the pre-existing disease waiting period varies with the health condition of the insured as well as the health insurance plan they choose.

How long do you have to wait for pre-existing conditions?

Pre-existing conditions exclusion

If you have a pre-existing condition when you enroll in health coverage, you may be subject to a pre-existing condition exclusion. This type of waiting period can last a maximum of 12 months, unless you're a late enrollee, in which case it can go up to 18 months.

What is the longest period of time an insurer may exclude coverage for pre-existing conditions in an LTC policy?

Policies covering long term care services may not contain a preexisting condition limitation of more than six months after the effective date of 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.

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.

Can life insurance deny you for pre-existing conditions?

While life insurance companies can charge higher premiums or deny coverage based on pre-existing conditions, there may still be policies available to high-risk life insurance candidates. The following are just some of the potential solutions available for those searching for life insurance with pre-existing conditions.

What are five things not covered by life insurance?

What are five things not covered by life insurance? The five things not covered by life insurance are preexisting conditions, accidents that occur while under the influence of drugs or alcohol, suicide, criminal activity, and death due to a high-risk activity, such as skydiving, and war or acts of terrorism.

What illnesses 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 blood pressure would fail a medical?

Once it rises above 180/110 you will fail the physical examination but if you can go away and reduce your blood pressure levels below 140/90 you can reapply.

What is the disability for high blood pressure?

Even if a person with high blood pressure has difficulty completing tasks at work, it is unlikely an individual will be approved for Social Security Disability benefits under a diagnosis of hypertension. There is no specific impairment listing for hypertension in Social Security's Blue Book.

What is high blood pressure that is not related to another medical condition?

Essential (primary) hypertension occurs when you have abnormally high blood pressure that's not the result of a medical condition. This form of high blood pressure is often due to obesity, family history and an unhealthy diet. The condition is reversible with medications and lifestyle changes.

Does chronic knee pain count as a disability?

Whether it is consistent discomfort or a complete inability to perform common tasks like driving and walking, your knee injury or chronic knee pain may qualify you for short-term disability or long-term disability.

Is chronic knee pain a disability?

If your knee issues are causing chronic joint pain, you have imaging demonstrating the cause of your knee pain (MRI, x-ray..), and your knee pain continues to affect your ability to walk despite following medical advice, you may be approved for disability.

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.