What is recurrence of pre-existing condition?
Asked by: Cali Jakubowski | Last update: November 3, 2025Score: 4.9/5 (6 votes)
How far back do insurance companies look for pre-existing conditions?
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.
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'.
What is an unexpected recurrence of a pre-existing condition?
An acute onset of a pre-existing condition is a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, of that gradually becomes worse over time, is not acute onset of a pre-existing condition.
What is the medicare rule for preexisting conditions?
Does Original Medicare cover preexisting conditions? Yes. When you sign up for Original Medicare, any preexisting condition will be covered immediately. You'll still be responsible for all out-of-pocket expenses like deductibles, copayments and coinsurance.
What Is a Pre-Existing Condition? | Health Insurance 101 | GoodRx
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.
What is the 3 year new patient rule for Medicare?
Special considerations for Medicare patients
Medicare has stated that a patient is a new patient if no face-to-face service was reported in the last three years. The group practice and specialty distinctions still apply, but “professional service” is limited to face-to-face encounters.
How do insurance companies determine pre-existing damage?
Adjusters often rely on photographic evidence from before and after the accident. Comparing these can help determine whether damages were pre-existing. Expert assessments. Sometimes, insurance companies will employ the expertise of mechanics or collision repair specialists to assess the vehicle's condition.
What is recurrence of condition?
Recurrence: The return of a sign, symptom, or disease after a remission. The reappearance of cancer cells at the same site or in another location is a form of recurrence.
What is the usual minimum waiting period for a pre-existing condition?
The length of time before the start date of coverage during which a condition would be considered pre-existing varies, and can be anywhere from 30 days to 6 months or longer.
What is the exclusion period for pre-existing conditions?
A pre-existing condition exclusion can not be longer than 12 months from your enrollment date (18 months for a late enrollee).
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.
Is acid reflux considered a pre-existing condition?
Is reflux really a pre-existing medical condition? The simple answer is yes.
How does car insurance know about pre-existing conditions?
Damage inspection can be performed during policy purchase or after a car accident. In both cases, the individual performing the inspection may uncover pre-existing damage. If you didn't report the damage, your insurer might still know about pre-existing damage through damage inspection.
Do insurance companies have access to medical history?
The answer varies depending on the state. In California, the retention period can be anywhere from two to ten years, depending on the type of procedure or healthcare provider. However, an insurance claim medical report should only look as far back as the injury in question.
How many years do insurance companies look back?
In California, accidents typically stay on your driving record for a period of three years from the date of the accident. During this time, the accident will be considered a public record and, therefore, accessible by insurance companies, potential employers, and law enforcement agencies.
What is the recurrence rule?
Recurrence rules define the interval at which the task repeats. Vulnerability Management implements recurrence rules per the RFC-5545 specification. The interval is formatted as a string of three (for scans) or four (for exports) values delimited by semi-colons.
Does recurrence mean stage 4?
What is Stage 4 breast cancer? Stage 4 breast cancer is advanced breast cancer that has metastasized, or spread, from the original location in the breast to other organs of the body, such as the bones, lungs, liver, or brain. Stage 4 breast cancer is also called metastatic breast cancer or breast cancer recurrence.
Do insurance companies still consider pre-existing conditions?
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.
How to negotiate property damage with insurance company?
- Know What You Want from the Insurance Company. ...
- Ask to See How the Insurer Valued Your Car. ...
- Don't Accept a Lowball Settlement Offer. ...
- Emphasize the Points in Your Favor. ...
- Document Everything Throughout the Process.
What are 3 factors that insurance companies look at to determine how much your insurance is going to cost?
- Location.
- Driving record.
- Credit history.
- Gender.
- Age.
- Marital status.
- Claims history.
- Car make and model.
What is the 5 year rule for Medicare?
This rule states that in order to be eligible for Medicare benefits, individuals must have lived in the U.S. as legal permanent residents for at least five continuous years.
How long before a patient is considered new again?
A new patient is one who has not received any professional services, [e.g., E/M service or other face-to-face service (e.g., surgical procedure)] from the physician or physician group practice (same physician specialty) within the previous 3 years.
What is the usual minimum waiting period for a pre existing condition under a Medicare?
In some cases, the Medigap insurance company can refuse to cover your out of pocket costs for these pre‑existing health problems for up to 6 months. This is called a “pre‑existing condition waiting period.” After 6 months, the Medigap policy will cover the pre‑existing condition.