What is the list of pre-existing conditions?


Editorial team Published on

A pre-existing condition is any physical or mental health issue, diagnosed or undiagnosed, that you had before your new health insurance coverage or policy started.

Common Pre-Existing Conditions

  • Metabolic and Cardiovascular: Diabetes (Type 1 and 2), high blood pressure (hypertension), high cholesterol, and heart disease.
  • Respiratory: Asthma, chronic obstructive pulmonary disease (COPD), and sleep apnea.
  • Serious and Chronic Illnesses: Cancer (or history of cancer), lupus, rheumatoid arthritis, epilepsy, kidney disease, and HIV/AIDS.
  • Mental Health: Depression, anxiety disorders, and substance use disorders.
  • Other Conditions: Obesity, past major surgeries, and pregnancy before enrollment.

How Insurance Handles Them

  • Coverage Rules: Under rules like the Affordable Care Act (ACA) in the U.S., marketplace health plans cannot deny you coverage or charge you more because of a pre-existing condition.
  • Waiting Periods: In many international or specific indemnity insurance frameworks, policies enforce a waiting period (often 24 to 48 months) before treatments related to pre-existing diseases are fully covered.
  • Disclosure: You must share your complete medical history when applying to avoid claim rejections or policy cancellations. You can review official guidelines through HealthCare.gov.