Key Takeaways:
- Any medical ailment or injury you had before to enrolling in a health insurance plan is considered a pre-existing condition.
- Under the Affordable Care Act, all pre-existing conditions are covered.
- Insurers are unable to refuse coverage to those with pre-existing medical issues.
- Insurance companies are not allowed to raise premiums or impose waiting periods on customers with pre-existing conditions.
Medical conditions and health issues that you had prior to the commencement date of your health insurance coverage are referred to as pre-existing conditions. Pre-existing illnesses can include pregnancy, diabetes, asthma, and cancer. Health insurance providers are prohibited by the Affordable Care Act (Obamacare) from denying you coverage due to any pre-existing conditions, raising your premium, or putting you through a waiting period. Plans that started on or after January 1, 2014 are subject to these Obamacare regulations.
What are pre-existing conditions?
Pre-existing conditions might include almost any medical issue you had before the insurance coverage began. A health insurance company’s definition of a pre-existing condition varies, so be careful to review the specifics of the plan before committing. Depending on the provider, even a relatively minor medical disease like tonsillitis, acne, high blood pressure, or irregular menstruation may be considered a health problem.
Pre-existing conditions that frequently impacted coverage prior to the ACA include:
- HIV/AIDS
- Cancer
- Cerebral palsy
- Depression as well as additional mental illnesses
- Alzheimer’s disease and dementia
- Diabetes
- Epilepsy
- Gender dysphoria
- Cardiovascular illness, CAD, and bypass surgery
- Haemorrhage
- Lupus
- Obesity
- Paralysis
- Immobility
- Being pregnant
- Pending hospital stay or operation
- Sleep apnoea
- Stroke
Are pre-existing conditions covered by health insurance?
Enrolling in a health insurance plan beginning on or after January 1, 2014, guarantees coverage of pre-existing conditions due to the Affordable Care Act. You cannot be denied health coverage by insurance companies due to a pre-existing condition, such as pregnancy. Additionally, it’s against the law for them to raise the cost of your plan only because you have a pre-existing condition. Just because something is covered by your plan doesn’t guarantee it will always be free or even reasonably priced; insurance companies do have a lot of discretion over how much they charge and what services they will cover.
Be aware that other kinds of health plans, such as short-term policies, either don’t cover pre-existing diseases at all or only do so at extremely high costs. Moreover, you might not be eligible for other insurance policies, including disability or life insurance, due to certain medical issues or past medical records.
What does this mean for you?
Yes, health insurance plans cover pre-existing conditions. Pre-existing condition coverage does, however, have some restrictions. Pre-existing disease clauses are included in most health insurance plans, meaning that any medical conditions or pre-existing diseases the insured had before to obtaining the policy will only be covered after a waiting time.