Can Insurance Deny Pre-existing Conditions?

by | Last updated on January 24, 2024

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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 are some examples of pre-existing conditions?

  • A pre-existing condition is a health problem you had before the date that your new health coverage starts.
  • Epilepsy, cancer, diabetes, lupus, sleep apnea, and pregnancy are all examples of pre-existing conditions.

How does insurance determine pre-existing condition?

While insurers generally determine the presence of a pre-existing condition

based on an applicant's current health status

, sometimes a healthy applicant can be deemed to have a pre-existing condition based on a past health problem or evidence of treatment for a particular condition.

What is the difference between existing and pre-existing?

You can use pre- in ways that are redundant, but it's a valid prefix, and

preexisting has its own meaning

. For instance, if you want to describe dinosaurs in relation to humans, existing doesn't work, but preexisting does.

Are pre existing conditions still covered?

Yes. 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.

Will my insurance cover an old medical bill?

Even if your insurance policy has been cancelled,

old bills can still be sent to your insurance

. The coverage still applies for care you received during the time the policy was in effect.

What is acute onset of pre existing conditions?

An acute onset of a pre-existing condition is defined as

a sudden and unexpected medical episode related to a pre-existing condition

. To be classified as acute onset, the medical event must occur spontaneously and without advance warning (either confirmed by a physician or by the obvious presence of symptoms).

Is back pain a pre-existing condition?

In essence, they're medical conditions that existed before your policy started. Some of the commonly understandable pre-existing conditions can be chronic illnesses like diabetes, high blood pressure, asthma etc.

The pre-existing conditions can include chronic injuries like back pain too.

Is arthritis considered a pre-existing condition?


Arthritis is generally considered pre-existing medical condition

. This doesn't necessarily mean you can't get travel insurance, but you do need to disclose your condition before you book your cover. With arthritis, you'll need to declare your specific type of arthritis whether it's osteo, rheumatoid, or psoriatic.

Is anxiety a pre-existing condition?

Not only do insurers have to offer coverage to people with

common pre-existing conditions

, like depression or anxiety, plans also have to cover treatment.

How long does a pre-existing condition last?

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.

What is another word for pre-existing?


foregoing


preceding

previous


earlier

former


antecedent

preexistent


established

prior


anterior

What is the most common medical condition?

  • obesity: 15%
  • cancer: 14%
  • diabetes: 2%
  • drug & alcohol abuse: 2%
  • heart disease: 1%
  • flu: 1%
  • mental illness: 1%
  • AIDS: 1%

What is a pre-existing cell?

All cells arise from pre-existing cells. Cells are the fundamental units of life which are produced by mitotic cell division of an existing cell. Thus the pre-existing cells are

the cells from which a new cell is formed by splitting in mitotic division

.

How do you use pre-existing in a sentence?

  1. Or maybe one policy will cover a pre-existing condition, but not another. …
  2. This observation led him to further work, and he succeeded in showing that in vascular organs the presence of cells in inflammatory exudates is not the result of exudation but of multiplication of pre-existing cells.

Does preexisting have a hyphen?

Although

the OED uses a hyphen in “preexisting,”

as do all the examples cited for this sense of the term, we'll follow the hyphenless spelling in The American Heritage Dictionary of the English Language (5th ed.) and Merriam-Webster's Collegiate Dictionary (11th ed.).

When did pre existing conditions begin?

In

March of 2010

, President Obama signed the Affordable Care Act. The law created the Pre-Existing Condition Insurance Plan (PCIP) to make health insurance available to people who've been denied coverage by private insurance companies because of a pre-existing condition.

Is the Affordable Care Act still in effect?

The Rest of the ACA Remains in Effect

Other than the individual mandate penalty repeal (and the repeal of a few of the ACA's taxes, including the Cadillac Tax),

the ACA is still fully in effect

.

How long can an insurer exclude coverage for a pre-existing condition?

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

.

What illnesses are not covered by insurance?

  • Congenital Diseases/Genetic Disordered. …
  • Cosmetic Surgery. …
  • Health issues due to consumption of drugs, alcohol, and smoking. …
  • IVF and Infertility Treatments. …
  • Pregnancy Treatment. …
  • Voluntary Abortion. …
  • Pre-existing Illnesses. …
  • Self-Inflicted injury.

Who gets the insurance check for my medical bills?

In most cases when an injured patient gives the hospital the name of the insurance company responsible for paying the patient's medical bills,

the insurance company

, in an effort to make sure the hospital will be paid, will send the check directly to the patient but with the check made payable to the patient (you) and …

Who is responsible for getting pre authorization?

If your health care provider is in-network, they will start the prior authorization process. If you don't use a health care provider in your plan's network, then you are responsible for obtaining the prior authorization.

What does the word acute mean in medical?

Overview. Acute conditions are

severe and sudden in onset

. This could describe anything from a broken bone to an asthma attack.

What is acute in biology?

Acute:

Of abrupt onset, in reference to a disease

. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care.

Carlos Perez
Author
Carlos Perez
Carlos Perez is an education expert and teacher with over 20 years of experience working with youth. He holds a degree in education and has taught in both public and private schools, as well as in community-based organizations. Carlos is passionate about empowering young people and helping them reach their full potential through education and mentorship.