What makes a condition pre-existing?
Asked by: Dr. Delaney Schowalter | Last update: January 2, 2024Score: 4.8/5 (9 votes)
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.
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.
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 is considered a pre-existing condition for pet insurance?
A pre-existing condition for cat or dog insurance is typically an illness or injury your pet shows signs of any time before the end of your pet insurance waiting period. This may include conditions not yet diagnosed by a veterinarian.
Is a birth defect considered a pre-existing condition?
A congenital condition is any abnormal condition present upon birth. Congenital conditions may not be detected until years after birth. Congenital conditions are considered pre-existing conditions.
What Is a Pre-existing Condition?
Can health insurance deny 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.
How do I hide pre-existing conditions on my pet insurance?
Pet parents can't hide their pets' pre-existing conditions or medical history from their provider. “When you first start a policy or upon your first claim with the pet insurance company, they will contact your vet for your pet's records,” says Snead.
Can I still get pet insurance after diagnosis?
Yes! Even if your dog or cat has a pre-existing condition, that won't exclude you from obtaining pet insurance. The costs of treating that particular issue won't be covered by your new plan, but you can expect coverage for future illnesses and injuries.
How to avoid pre-existing condition exclusion pet insurance?
The best way to avoid facing issues with pre-existing conditions is to enroll your pet in a policy while they are young and healthy. The sooner you enroll, the more likely it is that any future injuries and illnesses are covered by the policy.
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 12 month pre-existing condition clause?
The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.
Is anxiety disorder a pre-existing condition?
However, insurance companies may have a specific list of conditions they consider as pre-existing, especially if you purchase outside the open enrollment periods. These typically include anxiety and mood disorders, personality disorders, psychotic disorders and other mental and behavioral conditions.
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.
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.
Is pre-existing and existing the same?
A pre-existing situation or thing exists already or existed before something else.
Should I get pet insurance before or after vet visit?
I recommend getting pet insurance BEFORE ever bringing the pet in for an exam. In my experience, owners with pet insurance are able to make decisions based on expected prognosis rather than cost when they know that some or all of the veterinary care is covered.
Is it too late to get dog insurance?
Can I get pet insurance for older dogs and cats? Yes, older pets can get insurance, but your insurance premium may be higher compared to what you'd pay with a younger pet. Additionally, some insurance companies may have a maximum age limit for enrollment.
How long after setting up pet insurance can you claim?
Most pet insurance policies have a 14-day waiting period from the policy start date which means you cannot make a claim within the first two weeks.
Can you use pet insurance retroactively?
Can I Get Retroactive Pet Insurance? No, you cannot get retroactive pet insurance, meaning you can't buy a policy and have it be effective for a date that has already passed.
Can home insurance drop you for a dog?
Yes, it's possible for your homeowners insurance company to drop you because of a dog. Two reasons why your insurer might drop you is if your dog bit several people and you've filed multiple liability claims or if your dog's breed is on your insurer's list of banned dog breeds.
Why does home insurance ask if you have pets?
Having a dog can increase your cost for homeowners insurance. Pet ownership is one element that insurers use to determine risk. The exact cost of adding a dog to your homeowners insurance will depend on the breed and where you live, among other factors.
What is the 6 24 pre-existing condition exclusion?
A Pre-Existing Condition is excluded from coverage for period of [6-24] months following the Covered Person's Rider Effective Date. If the Covered Person is Diagnosed with a condition listed in this rider that is determined to be a Pre-Existing Condition, no benefit amount is payable for that listed condition.
What is a 12 12 pre-existing condition limitation?
A 12/12 pre-existing condition means that if you have a claim in the first twelve months, the insurance company will look back 12 months before you started the policy to see if you had a pre-existing condition that might have caused it.
What is a 3 6 pre-existing condition exclusion?
These provisions also include a treatment period, usually 3 months or 6 months, called the “pre-existing period.” This basically means that you cannot have been treated for, or taken prescribed medications 3 months before the effective date of coverage.