What is the definition of a pre-existing condition?

What is the definition of a pre-existing condition?

As defined most simply, a pre-existing condition is any health condition that a person has prior to enrolling in health coverage. A pre-existing condition could be known to the person – for example, if she knows she is pregnant already.

Can a health insurance company refuse to cover a pre-existing condition?

Pre-Existing Condition. 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. Learn more about coverage for pre-existing conditions.

What makes a person a pre-existing condition according to Kaiser?

Taking certain medications also could result in an insurance denial, including prescription drugs for arthritis, infertility, diabetes, cancer, mental health issues and anemia, according to Kaiser’s report.

What are some of the pre-existing conditions under the ACA?

A wide range of major and minor health issues could be considered pre-existing. Pre-ACA, common conditions that typically triggered an outright denial ranged from cancer, heart disease and diabetes to pregnancy, depression and sleep apnea, according to an analysis of major insurer underwriting guidelines by Kaiser Family Foundation.

What do insurance companies consider a pre-existing condition?

A pre-existing condition refers to a physical or mental condition caused by a medical illness or injury that existed before a person signed up with a health insurance provider. Objective standard and prudent person are two definitions used by insurance companies to define pre-existing conditions.

What counts as a pre-existing medical condition?

Chronic illnesses and medical conditions, including many forms of cancer, diabetes, lupus, epilepsy, and depression may be considered pre-existing conditions. Pregnancy before enrollment is also considered pre-existing and chronic, though less severe conditions such as acne, asthma, anxiety, and sleep apnea may also qualify.

Can insurance deny you for preexisting conditions?

Generally, insurance companies cannot deny coverage for individuals with preexisting conditions. All that the law allows for them to do is to impose penalties against the insured if the latter committed a material misrepresentation in his application for an insurance coverage.

What exactly is a pre-existing condition anyway?

A pre-existing condition is a medical condition that is excluded from coverage by an insurance company because the condition was believed to exist prior to the individual obtaining a policy from the particular insurance company.